Analgesic effect of adding magnesium sulfate to epidural levobupivacaine in patients with pre-eclampsia undergoing elective cesarean section

Anesthetic Conversion of Preexisting Labor Epidural Analgesia for Emergency Cesarean Section and Efficacy of Levobupivacaine with or Without Magnesium Sulphate: A Prospective Randomized Study

“…Also, our findings are in line with those of Elsharkawy et al (23), reporting that adding MgSO 4 to EA (in elective CS) had fast onset and prolonged duration of action with improved analgesic profile. Although they used higher dose of MgSO 4 (500 mg) than our study, there were no neonatal or maternal complications.…”

Magnesium sulfate reduces postoperative pain in women with cesarean section: A meta‐analysis of randomized controlled trials

“…The highest postoperative VAS remained lower after MgSO 4 use than in controls, irrespective of the type of anesthesia: general anesthesia 13,24,29,32 (WMD = −1.08, 95% CI = −1.77 to −0.39, p = 0.002, I 2 = 85.4%, p heterogeneity < 0.001), epidural 26 (WMD = −1.00, 95% CI = −1.13 to −0.87, p < 0.001), and spinal anesthesia 14,28,30 (WMD = −0.47, 95% CI = −0.52 to −0.42, p < 0.001, I 2 = 0.0%, p heterogeneity = 0.612; Figure 5A and Table ).…”

“…The highest postoperative VAS was not lower after MgSO 4 use than in controls in women with preeclampsia 14,26 (WMD = −0.64, 95% CI = −1.42 to 0.14, p = 0.106, I 2 = 87.8%, p heterogeneity < 0.001), but it was lower after MgSO 4 use than in controls when preeclampsia is not specified 13,24,28–30,32 (WMD = −0.77, 95% CI = −2.32 to −0.48, p < 0.001, I 2 = 85.2%, p heterogeneity < 0.001; Figure 5B and Table ).…”

“…From the 142 trials left, after reviewing the full texts, 24 were excluded because of study aim/ design, 10 for the outcomes, 47 for the population, 41 for the exposure (either without control groups or did not use MgSO 4 as an adjuvant to anesthetic management), and 6 because they were meta-analyses. Therefore, 14 RCTs were included, 13,14,16,23,24,26,[28][29][30][31][32][33][34][35] and 15 datasets were included because the study by Altiparmak et al 24 included 2 distinct experimental groups, each with its own control group (Table 1). A total of 880 women were included (440 in each group), with 40-80 women per study.…”

“…Five studies 13,26,[32][33][34] reported the total consumption of analgesia after surgery. MgSO 4 significantly decreased the 24-h consumption of analgesia compared to the control group (SMD = −3.20 mg of IV morphine equivalent, 95% CI = −5.45 to −0.95, p = 0.005, I 2 = 97.6%, p heterogeneity < 0.001; Figure 4B and Table S3).…”