Evaluation of the Efficacy of Magnesium Sulphate as an Adjuvant to Lignocaine for Intravenous Regional Anaesthesia for Upper Limb Surgery

Narang, Sumit; Dali, Jaspal Singh; Agarwal, Munisha; Garg, Rakesh

doi:10.1177/0310057x0803600614

Cited by 21 publications

(20 citation statements)

References 14 publications

(21 reference statements)

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“…Our results of recovery time of sensory blockade (mean ± SD) were found to be consistent with the finding of Narang et al 15 They found significant prolongation of recovery time of sensory block from 3.85 minutes in lignocaine alone and 5.71 minutes in lignocaine-magnesium group. Alayurt et al 17 found insignificant prolongation of recovery time of sensory block when clonidine was added to lignocaine for IVRA compared with lignocaine alone group but there was insignificant prolongation of recovery time of motor blockade (p > 0.05), which is consistent with our finding.…”

Section: Discussionsupporting

confidence: 92%

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Intravenous Regional Anesthesia: Comparing Efficacy of Magnesium Sulfate and Clonidine as an Adjuvant to Lignocaine for Intraoperative and Postoperative Analgesia

Solanki¹,

Singh²

2018

Journal on Recent Advances in Pain

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Objective: Intravenous regional anesthesia (IVRA) is used for short procedures for hand and upper limb surgeries. In terms of analgesia duration and quality of anesthesia, IVRA with adjuvants like opioids, muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs) increases the efficacy. We conducted this comparative study for evaluating the effect of adding magnesium sulfate and clonidine with lignocaine in IVRA for upper limb surgeries. Materials and methods: Seventy-five patients with American Society of Anesthesiologists (ASA) class I and II of either sex, age 18 to 60 years, undergoing upper limbs surgeries were enrolled. They were divided into three groups (25 each) according to drug received. Group L: 9 mL of 2% lignocaine (preservative-free) diluted with normal saline to make a total volume of 36 mL of 0.5% lignocaine. Group M: 3 mL of 50% magnesium sulfate with 9 mL of 2% lignocaine diluted with normal saline to make total volume of 36 mL, 0.5% lignocaine. Group C: 1 µg/kg clonidine with 9 mL of 2% lignocaine diluted with normal saline to make total volume of 36 mL of 0.5% lignocaine. Sensory and motor block (onset and recovery time), intraoperative tourniquet pain, first tramadol requirement time and mean tramadol dosage, quality of operative conditions, hemodynamic parameters, postoperative pain scores [in visual analog scale (VAS)] were recorded. Results: Both groups were comparable in terms of age, sex, ASA grade, baseline hemodynamic parameters, duration of surgery, and tourniquet inflation time. Shortened sensory and motor block onset times were established in M group (p < 0.05). Recovery from sensory and motor blockade was significantly prolonged in M group (p < 0.05). Anesthesia excellence as determined by anesthesiologist and surgeon was significantly better in C group as compared with rest of the two groups (p < 0.05). There was statistically significant difference (p > 0.05) in intraoperative VAS scores in groups M and C as compared with group L, throughout the procedure. Time to first analgesic requirement in group C was 43.04 ± 27.46 minutes, group M

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Section: Discussionsupporting

confidence: 92%

“…It has also been found that magnesium when added to lignocaine improves the quality of anesthesia and analgesia in IVRA. 15 In the present study, we evaluated and compared the effects of adding either magnesium sulfate or clonidine to lignocaine in IVRA for upper limb surgeries.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Regional Anesthesia: Comparing Efficacy of Magnesium Sulfate and Clonidine as an Adjuvant to Lignocaine for Intraoperative and Postoperative Analgesia

Solanki¹,

Singh²

2018

Journal on Recent Advances in Pain

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“…Magnesium sulfate,6566 ketamine, and ketorolac66 have also been used as adjuvants in IVRA, with variable results 6667. Clonidine has also been successfully used 68–70.…”

Section: Search Strategymentioning

confidence: 99%

Tourniquets in orthopedic surgery

Sharma

Salhotra

2012

IJOO

114

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Tourniquets are commonly used in limb surgeries, be it orthopedic or plastic surgeries. But the inflation pressures, the duration, and release guidelines are still not clear. According to a survey, majority of orthopedic surgeons inflate the tourniquet to fixed pressures for the upper and the lower limbs without considering the baseline blood pressure of the patient on whom the tourniquets are being applied. This review was designed to recall and review the safe use of tourniquets and the various techniques that can be employed to minimize the complications of tourniquet use. Google, science direct, and pubmed were searched for appropriate literature and relevant articles were identified.

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“…A similar study concluded that there is increased incidence of transient pain on magnesium sulphate injection. 23…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Analgesic Effect of Magnesium Sulphate in Intravenous Regional Anaesthesia- A Double Blind Study

Kumar¹,

Thabah²

2018

jebmh

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BACKGROUNDMagnesium antagonizes N-Methyl-D-Aspartate receptor, the receptor known to play an important role in the mechanism of pain. This study was undertaken to determine the effect of magnesium sulphate as an adjunct to lignocaine in Intra-Venous Regional Anaesthesia (IVRA). To evaluate the onset of anaesthesia, dose requirement of lignocaine, postoperative analgesia in upper limb surgeries. MATERIALS AND METHODSThis study was designed as a prospective, double blinded, randomised trial consisting of sixty patients. All selected patients were randomly divided into two groups. Saline group (n=30) who received fifteen millilitres of normal saline intravenously and magnesium group (n=30) who received magnesium sulphate 500mg in fifteen millilitre volume intravenously into the limb to be anaesthetised. Five millilitres of 1% lignocaine (preservative free) was administered every fifteen minutes and patients were assessed for loss of sensory and motor power, lignocaine requirement and postoperative analgesia. Data were analysed using Tukey and multivariate test. RESULTSThe mean time required to achieve surgical anaesthesia in magnesium group was 30.67±5.04 min and 53.17±5.65 min in saline group. Total dose of lignocaine required was 73.33±25.3 mg in magnesium group and 160.00±20.34 mg in saline group. Morphine requirement was 2.44±1.00 mg in magnesium group and 5.65±2.04 mg in saline group. Data showed statistically significant difference between the two groups (p=0.00). CONCLUSIONIt was concluded that magnesium as an adjunct fastens the onset of anaesthesia, reduces lignocaine requirement and prolonged postoperative analgesia. However, there was an increased incidence of transient pain with magnesium sulphate.HOW TO CITE THIS ARTICLE: Kumar M, Thabah R. Evaluation of analgesic effect of magnesium sulphate in intravenous regional anaesthesia-a double blind study.

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Evaluation of the Efficacy of Magnesium Sulphate as an Adjuvant to Lignocaine for Intravenous Regional Anaesthesia for Upper Limb Surgery

Cited by 21 publications

References 14 publications

Intravenous Regional Anesthesia: Comparing Efficacy of Magnesium Sulfate and Clonidine as an Adjuvant to Lignocaine for Intraoperative and Postoperative Analgesia

Intravenous Regional Anesthesia: Comparing Efficacy of Magnesium Sulfate and Clonidine as an Adjuvant to Lignocaine for Intraoperative and Postoperative Analgesia

Tourniquets in orthopedic surgery

Evaluation of Analgesic Effect of Magnesium Sulphate in Intravenous Regional Anaesthesia- A Double Blind Study

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