Ultrasound-guided transversus abdominis plane block for total abdominal hysterectomy: comparison between magnesium sulfate and dexamethasone as adjuvants

Gad, Mona; Nabil, Hanan; Elmetwally, Mohamed; Elzahaby, Islam A.

doi:10.4103/roaic.roaic_24_19

Cited by 4 publications

(5 citation statements)

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“…Our results are in agreement with Gad et al, who proved that the usage of 200-mg MgSO 4 was superior to 8 mg dexamethasone as an adjuvant to bupivacaine injected locally into TAP after total abdominal hysterectomy and concluded that MgSO 4 prolonged the duration of analgesia, decreased VAS scores postoperatively, and the number of demands for rescue analgesia more than dexamethasone [18]. Seyed et al, also studied the administration of 50mg / kg IV bolus of MgSO 4 to elective cesarean candidates before induction of general anesthesia and concluded that this could reduce acute post-operative pain and have a sparing effect on the morphine demands during the first 24 h [19].…”

Section: Discussionsupporting

confidence: 93%

Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

Abdelrahman¹,

Abusinna²

2021

TOATJ

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Introduction: The TAP block is a regional anesthetic technique, which blocks neural afferents between T6 and L1, which provide anterior abdominal walls and therefore help to alleviate postoperative pain. Aim: The aim is to compare the efficacy of preoperative single low dose of intravenous MgSO4 versus intravenous dexamethasone as adjuvants to ultrasound guided TAP block for prolongation of postcesaren analgesia. Materials and Methods: A total 60 pregnant females were selected undergoing elective caesarean sections under general anesthesia with ultrasound-guided transversus abdominis plane (TAP) block done at the end of surgery. Patients were randomly and equally allocated into three groups of 20 patients each. The first group of patients were classified as magnesium sulphate group (M)who received 50 mg/Kg IV, the second group of patients were classified as dexamethasone group (D) who received 2 mg IV and the third group was classified as the placebo group (C) who received IV saline. Results: Comparison of the VAS at 6 and 12 hours postoperatively showed statistically significantly lower values in group (M) and group (D) compared to group (C) and also group (M) was significantly lower than group (D) as well. The time interval until first rescue analgesia (Nalbuphine) needed by the patients (VAS ≥ 50) was significantly longer in group (M) compared to group (D) and group (C) consecutively. Additionally, it was significantly longer in group (D) than in the control group(C). The total dose of rescue analgesia consumed during the first 24 hours postoperatively was significantly lower in groups (M) than in group (D) and both groups showed lesser doses compared to group (C) Conclusion: We concluded that both MgSO4 and dexamethasone could prolong the postoperative duration and analgesic efficiency provided by the TAP block in cesarean sections. This further reduced the demands for postoperative rescue analgesia, with MgSO4 found to be more efficient than IV dexamethasone. Clinical Trial Registration Number: NCT04223128

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Section: Discussionsupporting

confidence: 93%

Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

Abdelrahman¹,

Abusinna²

2021

TOATJ

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“…[ 16 , 17 ] However, a study conducted by Gad et al . [ 18 ] using the same adjuvants in a TAP block for total abdominal hysterectomy showed that MgSO 4 provides prolonged analgesia compared to dexamethasone. This discrepancy could be due to different types of surgery and also they carried out the study under general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…However, Gad et al . [ 18 ] found lesser use of rescue analgesics in the magnesium group compared to the dexamethasone group in a study where they used TAP block for total abdominal hysterectomy. They administered block after general anaesthesia, while patients in our study received spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of bupivacaine with magnesium sulphate and dexamethasone as adjuvants in ultrasound-guided transversus abdominis plane block for open unilateral inguinal hernia surgeries: A randomised controlled trial

Padhi¹,

Shambhavi²,

Das³

et al. 2023

Indian J Anaesth

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Background and Aims: Inguinal hernia repair is associated with moderate to severe pain that is most extreme in the first 24 hours. The aim of this study was to compare the efficacy of dexamethasone versus magnesium sulphate (MgSO 4 ) with bupivacaine in ultrasound-guided transversus abdominis plane (TAP) block for patients undergoing unilateral inguinal hernioplasty. Methods: Eighty patients were randomly allocated to two groups to receive ultrasound-guided TAP block postoperatively with either 20 ml of 0.25% bupivacaine with 8 mg of dexamethasone (Group BD) or 20 ml of 0.25% bupivacaine with 250 mg of MgSO 4 (Group BM). Patients were assessed for the first 24 hours after surgery for pain at rest and movement using a numerical rating scale (NRS). Two mg/kg of tramadol was administered as rescue analgesia. The time to first demand tramadol, total consumption of tramadol, patient satisfaction score and side effects were evaluated. Results: The time to the first dose of rescue analgesia was significantly longer in BD group (596.13 ± 57.93 min) than in the BM group (422.50 ± 51.95 min). The NRS scores in the BD group were significantly lower compared to the BM group both at rest and on movement. The total requirement of tramadol was significantly less in the BD group (154.55 ± 59.11 mg) compared to the BM group (270.25 ± 105.72 mg). The incidence of side effects was lower and patient satisfaction was higher in BD group compared to BM group. Conclusion: Bupivacaine with dexamethasone in TAP block after unilateral open inguinal hernioplasty provides increased duration of analgesia and decreased requirement for rescue analgesics compared to magnesium sulphate, with lesser side effects and better patient satisfaction.

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“…[6][7][8] Magnesium may influence the central nervous system's (CNS) ability to transmit nociceptive signals and pain sensation in the central nervous system (CNS) by inhibiting N-methyl-D-aspartate (NMDA) receptor and calcium channels 9 and was used recently as a powerful analgesic adjuvant in pediatric loco-regional anesthesia, 10 resulting in reduced postoperative opioid requirements. 11 Our objective was to study the efficiency and safety of utilizing MgSO4 alongside levobupivacaine in bilateral US-TAP block for the management of postoperative pain in pediatric cancer patients underwent abdominal cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Magnesium may influence the central nervous system’s (CNS) ability to transmit nociceptive signals and pain sensation in the central nervous system (CNS) by inhibiting N-methyl-D-aspartate (NMDA) receptor and calcium channels 9 and was used recently as a powerful analgesic adjuvant in pediatric loco-regional anesthesia, 10 resulting in reduced postoperative opioid requirements. 11 …”

Section: Introductionmentioning

confidence: 99%

Magnesium Sulfate in Pediatric Abdominal Cancer Surgery: Safety and Efficacy in Ultrasound-Guided Transversus Abdominis Plane (US-TAP) Block in Conjugation with Levobupivacaine

El Sherif,

Sayed,

Fares

et al. 2023

LRA

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Magnesium sulfate (MgSO4) may enhance the effects of local anesthetics when used as an adjuvant in peripheral nerve blocks. Our objective was to evaluate efficiency and safety of utilizing MgSO4 alongside levobupivacaine in bilateral ultrasoundguided transversus abdominis plane (US-TAP) block for postoperative pain in pediatric cancer patients who underwent abdominal surgery. Methodology: A randomized double-blinded controlled trial at

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Ultrasound-guided transversus abdominis plane block for total abdominal hysterectomy: comparison between magnesium sulfate and dexamethasone as adjuvants

Cited by 4 publications

References 0 publications

Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

Comparing Intravenous Single Low Doses of Magnesium Sulphate versus Dexamethasone as Adjuvants to Ultrasound Guided Transversus Abdominis Plane (TAP) Block for Prolongation of Postcesarean Analgesia

Comparative evaluation of bupivacaine with magnesium sulphate and dexamethasone as adjuvants in ultrasound-guided transversus abdominis plane block for open unilateral inguinal hernia surgeries: A randomised controlled trial

Magnesium Sulfate in Pediatric Abdominal Cancer Surgery: Safety and Efficacy in Ultrasound-Guided Transversus Abdominis Plane (US-TAP) Block in Conjugation with Levobupivacaine

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