L’adjonction de sulfate de magnésium à la morphine en intrathécal améliore-t-elle l’analgésie après césarienne ?

Ghrab, B.; Maatoug, Mahdi; Kallel, N.; Khemakhem, K.; Chaari, M.; Kolsi, K.; Karoui, A.

doi:10.1016/j.annfar.2009.03.004

Cited by 22 publications

(4 citation statements)

References 25 publications

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“…In some studies, it was observed that the visual analog scores, first analgesic requirement and total morphine requirement were significantly lower after intrathecal injection of magnesium sulfate ( 12 , 14 ). In patients undergoing caesarean section under spinal anesthesia, the addition of intrathecal magnesium sulfate (100 mg) to morphine improved the quality and the duration of postoperative analgesia without increasing the incidence of adverse effects ( 15 ). Intrathecal magnesium was used for labor analgesia at the dose of 50 mg in addition to fentanyl; a significant prolongation in the duration of analgesia in the magnesium-fentanyl group compared with the fentanyl group was observed ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section

2015

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Background:Spinal anesthesia is widely used for caesarean section. Addition of intrathecal magnesium sulfate to local anesthetics seems to improve the quality of block and prolong the duration of analgesia.Objectives:The present study was designed to examine whether addition of intrathecal magnesium sulfate enhances the analgesic efficacy of intrathecal bupivacaine in patients undergoing cesarean section.Patients and Methods:We conducted a randomized, prospective, double-blind, case-control, clinical trial. Eighty patients were scheduled for cesarean section under spinal anesthesia. The patients were randomly allocated to receive either 10 mg of hyperbaric bupivacaine 0.5% (control group) or 10 mg of hyperbaric bupivacaine 0.5% plus 50 mg magnesium sulfate (case group) intrathecally. Hemodynamic variability, onset and duration of block and duration of analgesia were evaluated.Results:The onset of sensory blockade was delayed in case group compared with control group, and this was statistically significant. The onset of motor blockade had no difference in both groups. The duration of motor blockade was similar. Post-operative analgesia was longer in magnesium sulfate group but the difference was not meaningful. The intraoperative hemodynamic variability showed no significant differences between groups.Conclusions:This study showed that the addition of intrathecal magnesium sulfate to bupivacaine is not desirable in patients undergoing cesarean section due to the delay in the onset of sensory blockade and the lack of significant effects of magnesium on post-operative pain.

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Section: Discussionmentioning

confidence: 99%

Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section

2015

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“…[1013] In patients undergoing caesarean section under spinal anesthesia, the addition of intrathecal magnesium sulfate (100 mg) to morphine 100 mg improved the quality and the duration of postoperative analgesia without increasing the incidence of adverse effects. [20] In parturients with mild preeclampsia undergoing caesarean delivery, the addition of magnesium sulfate 50 mg to the intrathecal combination of bupivacaine and fentanyl prolongs the duration of analgesia and reduces the postoperative analgesic requirements without additional side-effects. [17] Intrathecal magnesium has been used for labor analgesia in the dose of 50 mg in addition to fentanyl, and the authors observed that there was significant prolongation in the median duration of analgesia (75 min) in the magnesium plus fentanyl group compared with the fentanyl alone group (60 min).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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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.

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“…Several studies demonstrated the analgesic effects of Magnesium when given with regional anesthesia [ 9 10 11 12 13 14 ]. Ozalevli et al [ 10 ], in 2005, observed that when Magnesium was added to Bupivacaine and an opioid (fentanyl) there was a prolongation of the period of anesthesia without additional side-effects.…”

Section: Discussionmentioning

confidence: 99%

The impact of magnesium sulfate as adjuvant to intrathecal bupivacaine on intra-operative surgeon satisfaction and postoperative analgesia during laparoscopic gynecological surgery: randomized clinical study

2017

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BackgroundSurgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia.MethodsSixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit.ResultsSurgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups.ConclusionsMagnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

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L’adjonction de sulfate de magnésium à la morphine en intrathécal améliore-t-elle l’analgésie après césarienne ?

Cited by 22 publications

References 25 publications

Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section

Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section

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

The impact of magnesium sulfate as adjuvant to intrathecal bupivacaine on intra-operative surgeon satisfaction and postoperative analgesia during laparoscopic gynecological surgery: randomized clinical study

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