The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal–epidural anaesthesia: a prospective double blind randomised study

Yousef, Ayman Abdelmaksoud; Amr, Yasser Mohamed

doi:10.1016/j.ijoa.2010.07.019

Cited by 61 publications

(49 citation statements)

References 14 publications

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“…The alternatives for sedation and analgesia (Barbi et al, 2005;Yousef and Amr, 2010;Borendal Wodlin et al, 2011) include local anesthesia (lidocaine, amethocaine hydrochloride mucilage) and general anesthesia (diazepam, midazolam, aethocaine, propofol, sevoflurane). Intravenous medication may cause safety problems, such as respiration depression (Yaster and Nichols, 2001;Mantadakis et al, 2009;Batra et al, 2010), while local anesthesia in lumbar punctures may not work due to patients' crying (Committee on Drugs and American Academy of Pediatrics, 2002;Draisci et al, 2009;Baniadam et al, 2010;Shadangi et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

et al. 2015

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ABSTRACT. This study explored the sedative and analgesic effects of fentanyl combined with propofol via an intrathecal chemotherapy injection for acute leukemia (acute lymphocytic leukemia or acute myelocytic leukemia) among children, to relieve pain and difficulty during intrathecal injection, improve treatment compliance, increase the success rate of single puncture, and reduce procedure failure, with the aim of developing a painless procedure for children with acute leukemia. Fifty person-times received fentanyl combined with propofol via an intrathecal chemotherapy injection among the hospitalized children with leukemia. The patients' cooperation with the procedure, response to the medication, dosages of fentanyl and propofol, reaction to the procedures, wake-up time, and changes in oxygen saturation (SpO 2 ), heart rate (HR), respiration, and blood pressure (BP) before, during, and after the procedures were observed. The doctors who performed the procedures assessed the quality of sedation and analgesia. In the treatment group, the patients were quiet during the lumbar puncture and intrathecal injection, showing good sedation and analgesia. HR and respiration decreased slightly. There were no changes in SpO 2 and BP. No obvious respiratory depression occurred with proper dosages. Only a few patients showed stertorous respiration, which stopped soon after the procedures. In the control group, the patients were agitated, crying, and not cooperative before and during the procedures, which made the procedures very difficult. During intrathecal injection, pain obviously reduced and the success rate of single lumbar puncture increased. It is safe and effective to apply fentanyl combined with propofol for sedation and analgesia.

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Section: Discussionmentioning

confidence: 99%

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

et al. 2015

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“…11,12 Recent literature also confirms the safety of magnesium administered through epidural or interathecal route. 3,6,7,13,14 Goodman and colleagues noted that larger doses (8.7gm, 9.6gm) of magnesium inadvertently administered into epidural space do not cause any neurological injury. 15 Our clinical trial also reiterates that the safety profile of epidurally administered MgSO4 is remarkably good.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial to evaluate the effect of addition of epidural magnesium sulphate on the duration of postoperative analgesia in patients undergoing lower abdominal surgeries under epidural anaesthesia

Gupta¹,

Goyal²,

Gupta³

et al. 2013

Sri Lankan J Anaesthesiol

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Abstract:Background: Noxious stimuli release excitatory neurotransmitters such as glutamate and aspartate, which bind to various receptors including N-methyl-D-aspartate (NMDA) receptors. Magnesium is a NMDA antagonist and has antinociceptive effects in animal and human models of pain. The addition of magnesium to postoperative epidural infusion may decrease postoperative pain and requirement of opioids.Methods: Sixty patients undergoing elective total abdominal hysterectomies were enrolled to receive either 1ml of magnesium sulfate (50 mg/ml) (Group M) or 1 ml of saline (Group C) in the epidural anaesthetic solution (9ml of 0.125% bupivacaine) for postoperative analgesia. Fentanyl 1µg/kg was given epidurally as rescue analgesia. Haemodynamic parameters, pain assessment using a visual analogue scale (VAS), and fentanyl consumption were recorded in the postoperative period.Results: There was significant difference between groups in the time to first analgesic requirement. Compared with Group C, patients in Group M received smaller doses of epidural fentanyl (P< 0.001). The cumulative fentanyl consumption in 24 h was significantly lower in Group M (119±56 mg) as compared to Group C(267.8± 92 mg)(P < 0.001). Patients in Group M had less pain as measured via VAS score in the first hour of the postoperative period (P < 0.001). The groups were similar with respect to haemodynamic and respiratory variables, sedation, pruritus, and nausea. Conclusion: Administration of magnesium to epidural local anaesthetic solution provides longer duration of postoperative analgesia and reduced postoperative fentanyl consumption without added side-effects.

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“…The possible analgesic effect of magnesium sulfate occurred at the central level and might be due to its absorption to the systemic circulation (11) . Perioperative efficacy of adjuvant addition of magnesium (10 mL of 5% magnesium sulfate) to epidural bupivacaine (10 mL of 0.25% plain bupivacaine) and fentanyl (100 μg) was demonstrated in women undergoing elective caesarean section (12) Ghatak et al evaluate the effect of 50 mg magnesium sulfate versus 150 mg clonidine as adjunct to 19 mL of epidural bupivacaine on 90 patients undergoing lower abdominal and lower limb surgeries; the onset of anesthesia in the magnesium group was faster. No statistically significant differences for both groups regard perioperative hemodynamics and postoperative side effects.…”

Section: Discussionmentioning

confidence: 99%

Effect of Adding Magnesium Sulphate to Pediatric Caudal Bupivacaine on Hemodynamics Parameters and Surgical Stress: Randomized Double-Blind Control Study

Aşkar¹,

Ahmed²,

Hassan³

2017

IAM

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Background: Caudal anesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants have been utilized with local anesthetic to prolong duration of post-operative analgesia of caudal block in pediatric patients, but with variable results. Aim and Objective: This study is conducted to evaluate the hemodynamics effects and surgical stress response of caudal magnesium sulfate with bupivacaine in children undergoing lower abdominal surgeries. Methods: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 children ASA classification I and II, aged 1 year to 6 years scheduled for lower abdominal surgeries randomized into one of two groups. after inhalation induction of general anesthesia, standard caudal block was done the participants were randomized into one of two groups either receive 1ml volume containing 50mg of magnesium sulfate (group Mg) added to 1ml /kg bupivacaine 0.25% or 1ml saline as placebo added to the same dose of bupivacaine in group (C). Postoperative pain assessed by FLACC score (acronym for Face, Legs, Activity, Cry and CONSOL ability) and duration of analgesia, postoperative sedation as well as hemodynamic parameters were compared between the two groups. Results: Group Mg had significantly lower FLACC score than group C in the first six postoperative hours. The sedation score was significantly higher only during the first postoperative hours in group Mg compared to group C. There was no statistically significant difference between groups about hemodynamic parameters at any time during the study period. Conclusion: Caudal magnesium sulfate 50mg enhance caudal block and prolongs duration of analgesia with bupivacaine in pediatric patient undergoing lower abdominal surgeries under general anesthesia with minimum adverse effects.

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The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal–epidural anaesthesia: a prospective double blind randomised study

Cited by 61 publications

References 14 publications

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

Rapid sedation induced by fentanyl combined with propofol via an intrathecal chemotherapy injection for leukemia in children

A randomized controlled trial to evaluate the effect of addition of epidural magnesium sulphate on the duration of postoperative analgesia in patients undergoing lower abdominal surgeries under epidural anaesthesia

Effect of Adding Magnesium Sulphate to Pediatric Caudal Bupivacaine on Hemodynamics Parameters and Surgical Stress: Randomized Double-Blind Control Study

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