The Effect of Intravenous Magnesium Sulphate Treatment on the Spinal Anaesthesia Produced by Bupivacaine in Pre-eclamptic Patients

Abstract

Objective: In our study, the effect of intravenous magnesium sulphate in normal and pre-eclamptic patients on spinal anaesthesia produced by bupivacaine was investigated.Methods: Sixty-four pregnant (32 normal and 32 pre-eclamptic) were accepted in this study. Pregnants were divided into four groups as patients given intravenous magnesium sulphate and as control. Spinal anaesthesia was induced with 12.5 mg 0.5% hyperbaric bupivacaine. Intraoperative and postoperative haemodynamic variables, sensorial block periods, onset times of sensorial and motor block, maximum sensorial block levels, the time to reach maximum block level, Bromage scores, consumptions of intraoperative analgesic and ephedrine, the quality of anaesthesia, the duration of spinal anaesthesia and magnesium levels in blood and cerebrospinal fluid were measured and recorded. Results:The level of magnesium in blood and cerebrospinal fluid was significantly higher in the group given magnesium in pre-eclamptic patients (p<0.01). Onset of sensory block times were significantly longer in intravenous magnesium group than in groups 1, 2 and 3 (p<0.05). Onset of motor block times were significantly longer and the duration of anaesthesia was shorter in groups given magnesium (p<0.05). Although the quality of anaesthesia was similar, supplemental analgesic consumption was significantly higher in pre-eclamptic pregnants given magnesium sulphate than in pre-eclamptic pregnants who were not given magnesium sulphate (p<0.05). Conclusion:Intravenous magnesium sulphate treatment during the spinal anaesthesia produced by bupivacaine extended the onset of sensory and motor block times, shortened the duration of spinal anaesthesia and therefore led to early analgesic requirement.Key Words: Spinal anaesthesia, magnesium sulphate, bupivacaine, pre-eclampsia Amaç: Çalışmamızda normal ve preeklamptik gebelerde intravenöz magnezyum sülfat tedavisinin bupivakain ile oluşturulan spinal anesteziye etkileri araştırıldı.Yöntemler: Çalışmamıza 32 normal sağlıklı, 32 preeklamptik toplam 64 gebe alındı. Olgular; intravenöz magnezyum sülfat tedavisi alan ve almayan olmak üzere toplam 4 gruba ayrıldı. Tüm gruplara 12,5 mg %0,5 hiperbarik bupivakain ile spinal anestezi uygulandı. İntraoperatif ve postoperatif hemodinamik değişkenler, sensoryal blok süreleri, sensoryal ve motor blok başlama süreleri, maksimum sensoryal blok seviyesi ve maksimum blok seviyesine ulaşma süreleri, bromage skorunun gerileme süreleri, intraoperatif analjezik ve efedrin gereksinimleri, anestezi kalitesi ve spinal anestezi süreleri ile kan ve beyin-omurilik sıvısı (BOS) magnezyum düzeyleri ölçülerek kaydedildi. Bulgular:Kan ve BOS magnezyum düzeyleri, magnezyum tedavisi alan preeklamptik gebelerde almayan gruplara göre önemli derecede yüksek bulundu (p<0,01). Sensoryal blok başlama zamanı grup intravenözde (IV) grup 1, 2 ve 3'e göre istatistiksel olarak önemli derecede uzun bulundu (p<0,05). Motor blok başlangıç sürelerinin magnezyum tedavisi uygulanan gruplarda önemli derecede uzun, anestezi sürelerinin ise...

Effect of intervenous magnesium sulfate on decreasing opioid requirement after surgery of the lower limb fracture by spinal anesthesia

“…Besides, block duration was shortened that led to increasing the need for initial analgesia. [7] In another study by Shah and Dhengle, results showed that sensory and motor block were, respectively, shorter about 34 min and 25 min in the control group. Postoperative requirement to analgesia in magnesium group was lower than control group (33% vs.…”

“…about effect of continuous magnesium sulfate infusion on spinal block characteristic;[6] in a study by Mustafa et al . about the effect of intervenous magnesium sulfate treatment on the spinal anesthesia produced by bupivacaine preeclamptic patients;[7] and in a study by Shah and Dhengle about magnesium sulfate for postoperative analgesia after surgery under spinal anesthesia. [8]…”