The Effect of Magnesium Sulfate on Postoperative Pain in Upper Limb Surgeries by Supraclavicular Block Under Ultrasound Guidance

Akhondzade, Reza; Nesioonpour, Sholeh; Gousheh, Mohammadreza; Soltani, Farhad; Davarimoghadam, Mohsen

doi:10.5812/aapm.14232

Cited by 15 publications

(22 citation statements)

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“…[ 10 11 12 13 ] Some authors also suggest a prolonged duration of analgesia when used as an adjunct to different local anesthetics. [ 14 15 ] However, in vivo , MgSO 4 was shown to shorten the effects of amide local anesthetics on the rat sciatic nerve. [ 16 ]…”

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confidence: 99%

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

et al. 2020

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Background: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO 4 ) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. Aims: The aim of this study was to evaluate the effect of MgSO 4 and ketamine on the duration of analgesia in brachial block. Settings and Design: This was a prospective, randomized, controlled double-blind study. Materials and Methods: One hundred and five adult patients were randomly divided into three groups: Group I = 27 mL of 0.5% ropivacaine; Group II = 27 mL of 0.5% ropivacaine + 250 mg MgSO 4 ; and Group II = 27 mL of 0.5% ropivacaine + 2 mg.kg −1 ketamine. Normal saline was added to make a total volume of 30 mL. The onset and duration of the sensorimotor blockade, quality and duration of postoperative analgesia, and adverse effects were assessed. Statistical Analysis: Statistical analysis was performed using SPSS, version 17.0 software (SPSS, Inc., Chicago, IL, USA). Chi-square test was used for nonparametric and ANOVA for parametric data. Post hoc Student's paired t -test was applied wherever indicated. The results were expressed as mean and standard deviation or numbers (%). P < 0.05 was considered as statistically significant. Results: The duration of analgesia was significantly longer in Group II (8.78 ± 0.97 h) compared to Group I (6.76 ± 0.92 h; P < 0.001) and Group III (7.1 ± 0.89 h; P < 0.001). Intervention groups had lower postoperative visual analog scores at 8, 12, and 24 h compared to the control group. Sedation, nystagmus, and hallucinations were observed in Group III. Conclusion: The addition of MgSO 4 to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia. MgSO 4 improves the quality of postoperative analgesia with lesser incidence of side effects when compared to ketamine.

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Section: Introductionmentioning

confidence: 99%

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

et al. 2020

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“…Lower limb surgery is performed under local, regional, or general anesthesia. Epidural anesthesia is a local anesthetic technique used in lower limb surgery (1-4). Modern orthopedic surgery aims at a faster onset of postoperative activity, mobility, and rehabilitation along with the least pain and discomfort.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Dexmedetomidine and Morphine as Adjuvants to Bupivacaine for Epidural Anesthesia in Leg Fracture Surgery: A Randomized Clinical Trial

et al. 2019

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BackgroundEpidural block approach and drugs are common options for improving the sensory and motor block duration and postoperative pain management.ObjectivesThe study aimed to compare the analgesic effects of dexmedetomidine and morphine as adjuvants to bupivacaine for epidural anesthesia in leg fracture surgery.MethodsThis prospective clinical trial was conducted on patients (n = 80, age range: 18 - 60 years) categorized as ASA class I or II. After a clinical examination, the patients were allocated to receive either lumbar epidural bupivacaine + morphine (BM) (12 mL bupivacaine 0.5% + morphine 2 mg) or bupivacaine + dexmedetomidine (BD) (12 mL bupivacaine 0.5% + dexmedetomidine 1 µg/kg). After drug administration, the sensory block level was assessed at 2-min intervals using the Cold Swab method until it reached the T12 level. At the T12 level of sensory block, the surgery began when motor block reached grade 3 of the modified Bromage scale.ResultsThe BD group had a significantly shorter time to reach the sensory and motor block than the BM group (P < 0.001). The duration of sensory and motor block was significantly longer in the group BD than in the BM group (P < 0.001). Moreover, the BD group showed lower VAS scores (P < 0.0001) and longer time to first analgesia demand than the BM group.ConclusionsCombined bupivacaine + dexmedetomidine prolongs the sensory and motor block duration and controls postoperative pain more effectively, indicating that it is an appropriate combination for epidural anesthesia.

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“…Local anesthesia is a safe and effective method in different surgeries such as upper extremity surgeries ( 1 ). This approach has several advantages over general anesthesia including lack of pain during operation, decreased postoperative pain and analgesic dose, more hemodynamic stability, and increased patients satisfaction ( 2 - 4 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

et al. 2018

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BackgroundTo improve the brachial plexus block (BPB) performance, different compounds have been used as adjuvants to local analgesics.ObjectivesThe aim of the present study was to investigate the effects of adding DEX to lidocaine on effectiveness of nerve block, and postoperative pain in forearm fracture surgery by supraclavicular BPB undergoing ultrasound-guided.MethodsThis was a double-blinded randomized clinical trial conducted on 72 patients with ASA classes I and II, which were candidates for forearm fracture surgery. In group A, patients received 3 mg/kg of lidocaine 2%. In group B, patients received 3 mg/kg of lidocaine 2% and DEX (1 µg/kg). The ultrasound-guided supraclavicular BPB was performed in all patients. The onset of sensory and motor blocks were evaluated with pin prick test and modified Bromage scale, respectively. The sensory and motor block moment was recorded as the onset of the block. The first analgesic request time, total consumed analgesic, adverse effect, and hemodynamic parameters of patients were recorded. A visual analog scale (VAS) was used for recording the severity of pain.ResultsThe two groups showed no significant difference in the demographic variables. The onset of sensory and motor block in the DEX groups was shorter. The duration of sensory and motor block, and analgesic request was significantly longer than the control groups. Total analgesic consumption 24 hours after surgery in the DEX groups was significantly lower. Moreover, hemodynamic status of patients in both groups was stable and no significant difference was observed between groups. This study showed that DEX, as an adjuvant to lidocaine, improve the characteristics of supraclavicular BPB and decrease the postoperative pain.

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The Effect of Magnesium Sulfate on Postoperative Pain in Upper Limb Surgeries by Supraclavicular Block Under Ultrasound Guidance

Cited by 15 publications

References 15 publications

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

Comparison of Dexmedetomidine and Morphine as Adjuvants to Bupivacaine for Epidural Anesthesia in Leg Fracture Surgery: A Randomized Clinical Trial

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

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