Sequence-Dependent Analgesic Efficacy of Ketamine and Magnesium Sulfate After Radical Nephrectomy.

What Was Tested

This randomized controlled trial looks at Vitamin D, K2, Magnesium and Zinc.

The primary outcomes were postoperative pain intensity (Numerical Rating Scale, NRS 0-10, at rest and on movement) and cumulative intravenous morphine consumption over 48 h, evaluated in patients undergoing open radical nephrectomy to test the hypothesis of sequence-dependent analgesic interaction.

Why It Was Studied

Background and Objectives: Ketamine and magnesium sulfate (MgSO4) are NMDA receptor antagonists that act through distinct mechanisms.

Preclinical data indicate that their analgesic interaction is sequence-dependent: ketamine administered before MgSO4 produces synergistic antinociception, whereas the reversed sequence is antagonistic.

Who Took Part

According to the abstract, 208 patients were involved.

By PubMed's age tags, the people studied were middle-aged adults and older adults, both men and women.

How the Study Was Run

The researchers set it up as a randomized, double-blind and placebo-controlled study.

Because people in this Vitamin D, K2, Magnesium and Zinc study were split into groups at random, differences between the groups are less likely to reflect who happened to join each one.

Blinding on both sides kept the patients and researchers unaware of who received Vitamin D, K2, Magnesium and Zinc.

The comparison arm used a placebo, so changes seen with Vitamin D, K2, Magnesium and Zinc could be set against what happens without it.

What Was Measured

Primary outcomes were postoperative pain intensity (NRS 0-10, at rest and on movement) and cumulative intravenous morphine consumption, assessed at 14 time points over 48 h.

Secondary outcomes included sedation, nausea, vomiting, and the presence of hallucinations.

Topics PubMed links to this paper include Ketamine, Magnesium Sulfate, Nephrectomy, Postoperative Pain, Analgesics and Pain Measurement.

Author keywords: NMDA receptor antagonist, central sensitization, multimodal analgesia, radical nephrectomy and sequence-dependent analgesia.

What This Means in Plain Language

The paper is a randomized, double-blind and placebo-controlled study of Vitamin D, K2, Magnesium and Zinc in 208 patients.

The publication is from 2026 (Medicina (Kaunas, Lithuania)), a journal based in Switzerland.

More context: the Vitamin D, K2, Magnesium and Zinc compound page, all human trials.