To evaluate the efficacy of intrathecal magnesium sulphate for hysterectomy under subarachnoid block with bupivacaine and fentanyl: A prospective randomized double blind clinical trial

Abstract

Background:Intrathecal magnesium has been found to prolong the duration of analgesia in various surgical procedures like lower limb surgeries and as adjuncts to general anesthesia for pain management. The present study was designed to examine whether addition of intrathecal magnesium sulfate would enhance the analgesic efficacy of intrathecal bupivacaine and fentanyl in patients undergoing total abdominal hysterectomy.Methods:After taking informed consent, 60 patients were randomised into two groups with 30 patients. Group “S” received 2.5 mL (12.5 mg) of hyperbaric bupivacaine + 0.5 mL (25 mcg) of fentanyl + 0.5 mL of normal saline and Group “M” received 2.5 mL (12.5 mg) of hyperbaric bupivacaine + 0.5 mL (25 mcg) of fentanyl + 0.5 mL (100 mg) of magnesium sulfate. Onset of sensory, motor block and duration of analgesia was noted.Results:Demographic profile and duration of surgery were comparable (P>0.5). Time of onset of sensory and motor blockade was delayed in Group M compared with Group S, and this was statistically significant. A statistically significant longer duration of analgesia was observed in Group M compared with the control Group S. However, the recovery of motor blockade was found to be statistically insignificant in both the groups. The hemodynamic parameters were comparable in the perioperative period (P>0.05). The incidence of side-effects in both the groups were also comparable (P>0.05).Conclusion:The addition of 100 mg intrathecal magnesium led to prolonged duration of analgesia significantly without increasing the incidence of side-effects. Also, there was a significant delay in the onset of both sensory and motor blockade.

Comparison of two different doses of magnesium sulphate for spinal anaesthesia: a prospective, randomized double-blind study

“…The duration of motor block was same in both the groups in another study. 19 Our study is similar to another study 24 where the authors compared different doses of magnesium sulphate and fentanyl as adjuvant to intrathecal bupivacaine in infraumbilical surgeries and concluded that the onset of sensory and motor block is prolonged in magnesium groups but the duration of sensory and motor block was similar to fentanyl group. More patients in group M100 in the present study had bradycardia (6/30) which responded to injection atropine 0.6mg (Table 3).…”

“…[17][18][19][20] In two studies 17,18 addition of different doses of intrathecal magnesium sulphate to hyperbaric bupivacaine was studied where as in a study 19 fentanyl was also used as adjuvant. Magnesium sulphate 100 mg as adjuvant to bupivacaine and saline was compared in another study.…”

Effects of Adding Intrathecal Magnesium Sulphate To Bupivacaine And Fentanyl in Lower Abdominal And Lower Limb Surgeries

“…There was significant delay in the onset time for sensory block in magnesium group in the studies conducted by Shukla et al (study group: 6.46± 1.33 min, control group: 4.14± 1.06 min) and Nath et al (study group: 10.1± 2.0 min, control group 5.2± 1.1 min) but in the present study though there is delay in magnesium group it is statistically insignificant. [10,11] In the study done by Sanad et al (study group: 4±0.5 min, control group: 3.2± 0.8) though there was delay in onset time but was comparable between two groups which is similar to our study. [12] The shorter onset time when compared to other studies can be attributed to a lower dermatomal level (T12) considered in our study, Shukla et al (T10) and in Nath et al (T8).…”

Evaluation the Effects of Intravenous vs. Spinal Dexmedetomidine during Anesthesia for Cesarean Sections with Severe Pre-Eclampsia

“…mechanisms of analgesic effect of dexmedetomidine. This antinociceptive action and safety of the use of dexmedetomidine on neonatal outcome is a very important issues which encourage us to use with spinal anesthesia either intravenously or intrathecally [8].…”