The effect of magnesium added to bupivacaine for arthroscopy: a meta-analysis of randomized controlled trials

Xiang, Weineng; Jiang, Lin; Shi, Langtao; Jiang, Chengming; Zhou, Yun; Yang, Chao

doi:10.1186/s13018-021-02609-w

Cited by 2 publications

(2 citation statements)

References 41 publications

(38 reference statements)

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“…So, it is optimal to combine it with MgSO4 to prolong postoperative analgesia, decrease the dose of analgesics, and protect chondrocytes. [7] In the recent era, the use of intrathecal (IT) adjuvants has gained traction due to its ability to extend the duration of the block, improve patient well-being, and decrease resource utilization compared with general anesthesia. [8] Currently, there is a gap in the literature regarding the use of IT MgSO4 in orthopedic surgery compared with the IV route of administration.…”

Section: Introductionmentioning

confidence: 99%

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Magnesium sulfate for postoperative pain in orthopedic surgery: A narrative review

Sbitan,

Nabhan,

Alafandi

et al. 2024

Medicine

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Magnesium Sulfate (MgSO4) is a widely used adjuvant in anesthesia. Often administered with local anesthetics, it is known to reduce analgesic and opioid consumption while extending the duration of analgesia. MgSO4 applications extend to orthopedic surgeries, cardiovascular and urogenital procedures, offering extended postoperative pain relief. While commonly administered through various routes, there is a research gap concerning the comparative efficacy of intrathecal (IT) and intravenous (IV) MgSO4 administration. This narrative review aims to provide a comparison between IT and IV administration of MgSO4 particularly following orthopedic procedures, where pain management is paramount. A comprehensive literature search was conducted across several electronic databases, trial registries, and gray literature from inception to 2023. Inclusion criteria encompassed studies investigating the effects of perioperative IT administration of magnesium compared to perioperative IV administration of MgSO4 in patients undergoing surgery, with no language restrictions. Our search identified 4326 articles, of which 9 randomized controlled trials met our inclusion criteria. We summarized these selected articles. Four studies discussed IT magnesium sulfate (MgSO4) administration, 2 focused on IT administration in orthopedic surgeries, and 3 explored both IV and IT administration of MgSO4 in orthopedic surgery. IT MgSO4 shows promise in postoperative pain management, delaying block onset and extending duration. Personalized administration choice, considering patient factors and surgery type, is crucial. Further research is needed to refine strategies for better patient outcomes, particularly following orthopedic surgeries.

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Section: Introductionmentioning

confidence: 99%

“…So, it is optimal to combine it with MgSO4 to prolong postoperative analgesia, decrease the dose of analgesics, and protect chondrocytes. [ 7 ]…”

Section: Introductionmentioning

confidence: 99%

Magnesium sulfate for postoperative pain in orthopedic surgery: A narrative review

Sbitan,

Nabhan,

Alafandi

et al. 2024

Medicine

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Opioid-free Anaesthesia and Analgesia in a Sickle Cell Disease Patient with Extensive Orthopaedic Soft-tissue Surgery

Ojo,

Adetoye,

Ibigbami

et al. 2023

Nigerian Journal of Medicine

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The provision of anaesthesia through techniques devoid of opioid is referred to as opioid-free anaesthesia. Both pain crisis in sickle cell (SC) disease and poor postoperative pain care worsens patient morbidity. This is a case report of a 22-year-old female SC anaemia patient, who had bilateral quadricepsplasty. Sickle Cell disease is common among individuals of African race and opioids are often abused during the out-of-hospital treatment of pain crisis. We report the case of pentazocine addiction resulting in severe bilateral quadriceps fibrosis. Thus, it was necessary to avoid opioid-based anaesthesia. A combined spinal epidural anaesthesia using magnesium adjunct was applied. The analgesic function of magnesium is linked to the blockade of the N-methyl-D-aspartate receptor. The subarachnoid block was achieved with 3.5 mL of 0.5% heavy bupivacaine (17.5 mg), while epidural anaesthesia was done with 14 mL of 0.25% plain bupivacaine (37.5 mg) and 1 mL of 2 mg/kg of magnesium, (i.e., 120 mg). After the surgery, the surgical sites were infiltrated with 10 mL of 0.25% plain bupivacaine (25 mg) on each limb. Intravenous magnesium-sulfate 5 mg/kg (i.e., 300 mg), was added to 500 mL of crystalloids to run every 4 h. Furthermore, 1 mL of 2 mg/kg magnesium, (i.e., 120 mg,) was added to the 14 mL of 0.125% plain bupivacaine to make 15 mL of magnesium–bupivacaine admixture, every 4 h. These were given for 48 h. The Visual Analog Scale pain scores reduced from 9/10 to 5-6/10 and then to 3/10 over a 6-h period and remained at or lower than 3/10 throughout the postoperative period. Adequate haemodynamics, oxygenation, hydration, warmth, and urine output were ensured. The postoperative period was crisis free.

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The effect of magnesium added to bupivacaine for arthroscopy: a meta-analysis of randomized controlled trials

Cited by 2 publications

References 41 publications

Magnesium sulfate for postoperative pain in orthopedic surgery: A narrative review

Magnesium sulfate for postoperative pain in orthopedic surgery: A narrative review

Opioid-free Anaesthesia and Analgesia in a Sickle Cell Disease Patient with Extensive Orthopaedic Soft-tissue Surgery

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