Main Article Content
Abstract
BACKGROUND
In this study, we wanted to compare the characteristics of subarachnoid block when intrathecal versus intravenous magnesium sulphate was used with 0.5 % hyperbaric bupivacaine spinal anaesthesia in elective infraumbilical surgery.
METHODS
This was a hospital based prospective randomized clinical parallel arm study double-blinded (patient and observer blinded) single hospital study conducted among 100 patients who presented with elective infraumbilical surgery under spinal anaesthesia to the Department of Anesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati, from 1st June 2021 to 31st May 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
RESULTS
The onset of sensory block, and comparison of duration of analgesia with respect to time to first analgesic request was found to be statistically significant. While comparing, duration of analgesia was significantly prolonged in the intravenous group. Magnesium administered intravenously or intrathecally was not linked to any harmful side effects.
CONCLUSIONS
Infraumbilical procedures that use intravenous magnesium sulphate as an adjuvant to 0.5% hyperbaric bupivacaine spinal anaesthetic extend the time that post-operative analgesia lasts. Intrathecal co-administration of Magnesium sulphate with 0.5% hyperbaric bupicavaine delays the onset of sensory block compared to intravenous MgSO4.
Keywords
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References
- Olawin AM, Das JM. Spinal anesthesia. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2022.
- Morrison AP, Hunter JM, Halpern SH, et al. Effect of intrathecal magnesium in the presence or absence of local anaesthetic with and without lipophilic opioids: a systematic review and meta-analysis. Br J Anaesth 2013;110(5):702-12.
- Khangure N. Adjuvant agents in neuraxial blockade anaesthesia tutorial of the week 230. Anaesthesia tutorial of the week. 2011.
- Dalai HK, Nanda S, Chavali S. A clinical comparison between intrathecal and intravenous infusion of magnesium sulphate as an adjuvant to hyperbaric 0.5% bupivacaine in spinal anaesthesia for elective infraumbilical surgeries. Annals of International Medical and Dental Research 2017;3(2):23-9.
- Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation: implications for the treatment of post injury pain and hypersensitivity states. Pain 1991;44:293-9.
- Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J 2012;5(Suppl 1):i3-i14.
- Thurnau GR, Kemp DB, Jarvis A. Cerebrospinal fluid levels of magnesium in patients with preeclampsia after treatment with intravenous magnesium sulphate: a preliminary report. Am J Obstet Gynaecol 1987;157(6):1435-8.
- Paul S, Bhattactarjee DP, Ghosh S, et al. Efficacy and safety of intrathecal magesium sulphate as an adjunct to bupivacaine for lower limb orthopaedic surgery. Pharmacology Online 2009;2:570-4.
- Lee JW, Kim MK, Shin Y, et al. The analgesic effect of single dose of intrathecal magnesium sulphate. Korean J Anesthesiol 2007;52:72-6.
References
Olawin AM, Das JM. Spinal anesthesia. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2022.
Morrison AP, Hunter JM, Halpern SH, et al. Effect of intrathecal magnesium in the presence or absence of local anaesthetic with and without lipophilic opioids: a systematic review and meta-analysis. Br J Anaesth 2013;110(5):702-12.
Khangure N. Adjuvant agents in neuraxial blockade anaesthesia tutorial of the week 230. Anaesthesia tutorial of the week. 2011.
Dalai HK, Nanda S, Chavali S. A clinical comparison between intrathecal and intravenous infusion of magnesium sulphate as an adjuvant to hyperbaric 0.5% bupivacaine in spinal anaesthesia for elective infraumbilical surgeries. Annals of International Medical and Dental Research 2017;3(2):23-9.
Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation: implications for the treatment of post injury pain and hypersensitivity states. Pain 1991;44:293-9.
Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J 2012;5(Suppl 1):i3-i14.
Thurnau GR, Kemp DB, Jarvis A. Cerebrospinal fluid levels of magnesium in patients with preeclampsia after treatment with intravenous magnesium sulphate: a preliminary report. Am J Obstet Gynaecol 1987;157(6):1435-8.
Paul S, Bhattactarjee DP, Ghosh S, et al. Efficacy and safety of intrathecal magesium sulphate as an adjunct to bupivacaine for lower limb orthopaedic surgery. Pharmacology Online 2009;2:570-4.
Lee JW, Kim MK, Shin Y, et al. The analgesic effect of single dose of intrathecal magnesium sulphate. Korean J Anesthesiol 2007;52:72-6.