The effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anesthesia

Abstract

Trial design: The current study is a meta-analysis designed to assess the effect of adding magnesium to a combination of intrathecal bupivacaine and fentanyl. Methods: The protocol was registered in PROSPERO with the number CRD42020177618. PubMed, Cochrane library, Web of Science, and Google Scholar were searched for randomized controlled trials investigating the effect of adding magnesium to a combination of intrathecal bupivacaine and fentanyl. The continuous data were presented as Ratio of means (RoM). Risk ratio (RR) along with 95% confidence interval (CI) was utilized to assess the dichotomous data. Results: Ten trials were involved in the present study with 720 adult patients. Compared with control, intrathecal magnesium prolonged time to the first analgesic requirement by an estimate of 1.23 (RoM: 1.23; 95%CI: 1.13–1.33; P < .00001), prolonged adequate sensory block duration for surgery by an estimate of 1.16 (RoM: 1.16; 95%CI: 1.05–1.27; P = .003), delayed time to maximum sensory level by an estimate of 1.38 (RoM: 1.38; 95%CI: 1.07–1.78; P = .01) and reduced the incidence of shivering following spinal anesthesia (risk ratio: 0.38; 95%CI: 0.18 to 0.81, P = .01) without influence on time to full motor recovery or incidences of hypotention, bradycardia, nausea, and vomiting or pruritis. Conclusion: Intrathecal magnesium, when added to a combination of intrathecal bupivacaine and fentany, prolongs the analgesic duration of spinal anesthesia without increased incidences of side effects.

Effect of Intravenous Injection of Magnesium Sulphate on Intraoperative End-Tidal CO2 Level and Postoperative Pain in Laparoscopic Cholecystectomy

“…Magnesium acts as an antagonist for NMDA receptors and can relieve pain. The pain relief effect of magnesium has been confirmed in intra- and postoperative periods ( 19 - 21 ).…”

Perioperative Magnesium for Postoperative Analgesia: An Umbrella Review of Systematic Reviews and Updated Meta-Analysis of Randomized Controlled Trials

“…Sixteen included studies were systematic reviews and meta-analyses of RCTs, while one study was a systematic review of RCTs [21]. Routes of magnesium administration were intravenous in seven studies [21][22][23][24][25][26][27], intrathecal and/or epidural in five [16,17,[28][29][30], and intra-articular in two [31,32]. There were several routes, including intravenous, intrathecal, epidural, and local approaches, in three studies [17,18,20].…”

“…Summarized evidence on analgesic consumption is shown in Table 3. Nine studies performed meta-analyses to assess the time interval to the first analgesic request following surgery [17,22,24,[27][28][29][30][31][32]. Time to first analgesic request was significantly shorter in the majority of studies although heterogeneity was substantial; the details are presented in Table 4.…”

bupivacaine , pethidine and sole pethidine on the hemodynamic status and duration of sensory and motor block: A randomized clinical trial in iran

“…It is an NMDA antagonist that reduces central sensitization. These receptors are activated by surgical stimulus (7). Studies demonstrated no signi cant side effects in intrathecal magnesium sulfate injection (8, 9).…”