Clinical effects of intrathecal midazolam versus intrathecal magnesium sulfate as adjunctsto hyperbaric bupivacaine: A comparative study

Shashni, Sapna; Nair, Abhijit; Gopal, T V S

doi:10.4103/0970-5333.124604

Cited by 3 publications

(2 citation statements)

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“…The delayed onset with magnesium is mainly due to change in baricity which leads to slower ascent of the drug. Onset of motor blockade was also delayed with magnesium in study done by Özalevli et al, 14 and Shashni et al 15 The duration of sensory block and motor block in Group F was prolonged as compared to Group M and the difference was highly significant (P<0.001) (Table 2).…”

Section: Discussionmentioning

confidence: 81%

Effect of addition of intrathecal preservative free magnesium sulfate with 0.5% bupivacaine heavy and fentanyl with 0.5% bupivacaine heavy on post-operative pain relief in patients undergoing hysterectomy

Gupta

Tandon

Jain³

et al. 2023

Asian J Med Sci

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Background: Spinal anesthesia is the most common neuraxial anesthesia for infraumblical surgeries. The use of various adjuvants has become popular in today’s scenario to enhance its quality. Aims and Objectives: The aim of this study was to evaluate the onset, duration of sensory and motor block, hemodynamic effects (if any), duration of post-operative analgesia, and adverse effects of fentanyl or magnesium given intrathecally with 0.5% bupivacaine heavy in patients undergoing hysterectomy. Materials and Methods: This prospective randomized double-blinded study was conducted in total sixty patients undergoing hysterectomy, divided into two groups of 30 patients each. Group F received 25 μg fentanyl with 3 mL 0.5% bupivacaine heavy and Group M received 100 mg magnesium sulfate with 3 mL 0.5% bupivacaine heavy. The onset and duration of sensory and motor blockade, duration of analgesia, hemodyamics, and side effects were assessed. Results: The mean time of onset of sensory and motor block was less in fentanyl (P<0.001). Duration of sensory, motor block, and duration of analgesia was more in fentanyl group (P<0.001), whereas incidence of side effects such as bradycardia, hypotension, and shivering was less in magnesium. Conclusion: Our study concluded that addition of fentanyl as adjuvant effectively augmented the quality of spinal anesthesia, but magnesium provided stable hemodynamics and lesser side effects as compared to fentanyl.

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Section: Discussionmentioning

confidence: 81%

Effect of addition of intrathecal preservative free magnesium sulfate with 0.5% bupivacaine heavy and fentanyl with 0.5% bupivacaine heavy on post-operative pain relief in patients undergoing hysterectomy

Gupta

Tandon

Jain³

et al. 2023

Asian J Med Sci

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“…The number of cases with complications (Figure .2) was minimal and statistically insignificant among the groups in our study like other studies. (21,22,23) Nausea, vomiting and pruritus of a mild nature was observed to be slightly higher only with 300µg subarachnoid buprenorphine by Ipe et al (24) and even though higher doses of intrathecal magnesium reported better analgesic efficacy it was at the cost of higher occurrence of adverse effects such as hypotension, nausea and shivering. (25) Ozgodam et al (26) observed by electron microscopic examination, that intrathecal magnesium sulphate administration induced neurodegeneration in rats but recently intrathecal magnesium has been studied to be safe and with beneficial effects.…”

Section: Discussionmentioning

confidence: 96%

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

Bafna,

Ponnusamy

2021

IJMBS

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Aims: An adjuvant to a local anaesthetic can potentiate spinal anesthesia and provide better postoperative analgesia. Our study has been drafted to evaluate and compare the analgesic potency of the adjuvants, buprenorphine and magnesium, to intrathecal 0.5% hyperbaric bupivacaine. Methods: One hundred and fifty patients by inclusion criteria posted for an elective lower abdominal surgery were randomised into three groups of 50 each. They received 3ml of 0.5% hyperbaric bupivacaine with either 1ml of 0.9% Saline or 1ml of buprenorphine (60?g) or 1ml of magnesium sulphate (50mg). Time for first rescue analgesia, onset of sensory and motor blocks, time to two-segment regression and duration of motor block, haemodynamic parameters, and side effects were studied. Data was analyzed with ANOVA, Kruskal-Wallis H, Chi-square and Fischer’s exact tests. Our Study was carried out from January 2020 to April 2020. Results: The time for first analgesic request was 248.70> 186.84> 141.44 minutes (Buprenorphine> magnesium> control), p<0.001. The onset of sensory and motor blocks was faster in buprenorphine group compared to magnesium and control groups. The time to two-segment regression and duration of motor block was significantly prolonged in buprenorphine and magnesium groups compared to control group. Conclusion: The time to first analgesic request was longer with buprenorphine compared to magnesium sulphate with adequate sedation and negligible complications. Hence, addition of adjuvant buprenorphine (60?g) has a better demonstrable role in postoperative analgesia compared to adjuvant magnesium (50mg) or 0.5% hyperbaric bupivacaine alone. Keywords: Spinal Anaesthesia; Intrathecal buprenorphine; Intrathecal magnesium; Analgesic efficacy; Intrathecal adjuvants

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Evaluation of intrathecal midazolam (2mg) as an adjuvant to bupivacaine (0.5%) for spinal anaesthesia in orthopaedic surgery: A case control study

Sharma¹,

Pathania²,

Verma³

et al. 2022

IJCA

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Spinal anaesthesia is being routinely used for lower abdominal and lower limb surgeries. Bupivacaine is the commonly used anaesthetic agent because of its longer duration of action. Various intrathecal adjuvants like midazolam are sometimes added to enhance the anaesthetic effects and increase the duration of analgesia. We, hereby evaluated the effects of intrathecal midazolam 2mg as an adjuvant to bupivacaine during spinal anaesthesia in orthopaedic surgery. A total of 60 patients of age 20-50 years were randomly divided into two groups: BM-who received 3.2ml bupivacaine and 0.4ml(2mg) midazolam; and BS-who received 3.2 ml bupivacaine and 0.4ml normal saline. Mean duration of analgesia was prolonged in the midazolam group (429.33+/-59.54 min) as compared to controls (252+/-42.22 min) (p=0.00). The number of injection diclofenac as rescue analgesic were also significantly less in BM group. Time to achieve maximum sensory level(T4) was also significantly less in BM group. Time to two segment regression and the duration of motor block were more in the midazolam group. Intrathecal midazolam as an adjuvant significantly prolongs the duration of analgesia and decreases the requirement of rescue analgesia when combined with bupivacaine during spinal anaesthesia. The dose of 2mg seems to safe and effective to achieve the desired results.

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Clinical effects of intrathecal midazolam versus intrathecal magnesium sulfate as adjunctsto hyperbaric bupivacaine: A comparative study

Cited by 3 publications

References 0 publications

Effect of addition of intrathecal preservative free magnesium sulfate with 0.5% bupivacaine heavy and fentanyl with 0.5% bupivacaine heavy on post-operative pain relief in patients undergoing hysterectomy

Effect of addition of intrathecal preservative free magnesium sulfate with 0.5% bupivacaine heavy and fentanyl with 0.5% bupivacaine heavy on post-operative pain relief in patients undergoing hysterectomy

Buprenorphine Versus Magnesium Sulphate: Adjuvants to Intrathecal Hyperbaric Bupivacaine for Lower Abdominal Surgeries

Evaluation of intrathecal midazolam (2mg) as an adjuvant to bupivacaine (0.5%) for spinal anaesthesia in orthopaedic surgery: A case control study

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