Effects of Adding Two Different Doses of Intrathecal Magnesium Sulfate to Bupivacaine in Laminectomy Surgeries under Spinal Anesthesia

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Spinal anesthesia is a popular anesthetic technique in laminectomy due to less complication and more satisfaction of patients and surgeons. In this technique, duration and quality of block is important to control postoperative pain. The aim of this study was to evaluate the effect of adding two different doses of magnesium sulfate to bupivacaine on block characteristics and postoperative pain in laminectomy under spinal anesthesia.Methods: In a prospective clinical trial study, 120 candidates of elective laminectomy under spinal anesthesia with bupivacaine were randomly divided to three groups of receiving 50 mg magnesium sulfate (M50), 100 mg magnesium sulfate (M100) and normal saline (N). The onset and duration of sensory and motor block, maximum level of block, time of analgesic requirement and its dose were measured and recorded.Findings: The mean onset time of sensory block in M50 (16.9 ± 4.0 minutes) and M100 (18.5 ± 2.4 minutes) were significantly more than control group (12.6 ± 3.57 minutes). The duration of sensory block was 89.80 ± 12.79, 116.50 ± 12.00, and 119.00 ± 18.50 minutes in control, M50, and M100 groups, respectively, with significant difference. Mean onset time of motor block in both M50 (11.80 ± 4.20 minutes) and M100 (12.6 ± 3.80 minutes) groups and were significantly more than control group (9.40 ± 3.33 minutes). The pain intensity was significantly more in control group. The mean time of first analgesic requirement and its total dose were significantly lower in M100 than other groups (P ˂ 0.050 for all)Conclusion: Adding 100 mg intrathecal magnesium sulfate in comparison with 50 mg provides more acceptation effects such as less sensation of pain, less analgesic consumption and prolonged first time of analgesic requirement with no significant side effect.

Keywords

References

  1. Attari MA, Mirhosseini SA, Honarmand A, Safavi MR. Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial. J Res Med Sci 2011; 16(4): 524-9.
  2. Okojie N, Ekwere I, Imarengiaye C. Augmented bupivacaine spinal anaesthesia in postoperative analgesia. J West Afr Coll Surg 2012; 2(3): 24-41.
  3. Saeidi M, Aghadavoudi O, Sadeghi MM, Mansouri M. The efficacy of preventive parasternal single injection of bupivacaine on intubation time, blood gas parameters, narcotic requirement, and pain relief after open heart surgery: A randomized clinical trial study. J Res Med Sci 2011; 16(4): 477-83.
  4. Thakur A, Bhardwaj M, Kaur K, Dureja J, Hooda S, Taxak S. Intrathecal clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing inguinal herniorrhaphy: A randomized double-blinded study. J Anaesthesiol Clin Pharmacol 2013; 29(1): 66-70.
  5. Agarwal D, Chopra M, Mohta M, Sethi AK. Clonidine as an adjuvant to hyperbaric bupivacaine for spinal anesthesia in elderly patients undergoing lower limb orthopedic surgeries. Saudi J Anaesth 2014; 8(2): 209-14.
  6. Ammar AS, Mahmoud KM. Does the addition of magnesium to bupivacaine improve postoperative analgesia of ultrasound-guided thoracic paravertebral block in patients undergoing thoracic surgery? J Anesth 2014; 28(1): 58-63.
  7. Ozalevli M, Cetin TO, Unlugenc H, Guler T, Isik G. The effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia. Acta Anaesthesiol Scand 2005; 49(10): 1514-9.
  8. Jabalameli M, Pakzadmoghadam SH. Adding different doses of intrathecal magnesium sulfate for spinal anesthesia in the cesarean section: A prospective double blind randomized trial. Adv Biomed Res 2012; 1: 7.
  9. Khalili G, Janghorbani M, Sajedi P, Ahmadi G. Effects of adjunct intrathecal magnesium sulfate to bupivacaine for spinal anesthesia: a randomized, double-blind trial in patients undergoing lower extremity surgery. J Anesth 2011; 25(6): 892-7.
  10. Banihashem N, Hasannasab B, Esmaeili A, Hasannasab B. Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section. Anesth Pain Med 2015; 5(3): e22798.
  11. Dayioglu H, Baykara ZN, Salbes A, Solak M, Toker K. Effects of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in knee arthroscopy. J Anesth 2009; 23(1): 19-25.
  12. James MF. Clinical use of magnesium infusions in anesthesia. Anesth Analg 1992; 74(1): 129-36.
  13. Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation; implications for the treatment of post-injury pain hypersensitivity states. Pain 1991; 44(3): 293-9.
  14. Woolf CJ, Chong MS. Preemptive analgesia--treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993; 77(2): 362-79.
  15. Liu HT, Hollmann MW, Liu WH, Hoenemann CW, Durieux ME. Modulation of NMDA receptor function by ketamine and magnesium: Part I. Anesth Analg 2001; 92(5): 1173-81.
  16. Buvanendran A, McCarthy RJ, Kroin JS, Leong W, Perry P, Tuman KJ. Intrathecal magnesium prolongs fentanyl analgesia: a prospective, randomized, controlled trial. Anesth Analg 2002; 95(3): 661-6, table.
  17. Lejuste MJ. Inadvertant intrathecal administration of magnesium sulfate. S Afr Med J 1985; 68(6): 367-8.
Journal of Isfahan Medical School
Volume 35, Issue 419 - Serial Number 419
January and February 2017
Pages 104-110

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History

  • Receive Date: 06 December 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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