Intrathecal Magnesium Sulphate as an Adjuvant to Bupivacaine for Lower Limb Orthopaedic Surgeries: A Randomized Controlled Trial
Creators
- 1. Consultant Anesthesiologist, Department of Anesthesia, VS General Hospital, Ahmedabad, Gujarat, India
- 2. Associate Professor, Department of Anesthesiology, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India
Description
Abstract
Background and Aim: Intrathecal adjuvants have gained popularity for prolonging duration and quality of
subarachnoid block. Hence, this study was undertaken to evaluate the effect of addition of magnesium sulphate
with bupivacaine (hyperbaric) in spinal anesthesia for prolongation of analgesia.
Material and Methods: This randomized controlled study enrolled 80 patients, comprising both males and
females with American Society of Anesthesiologists physical status I or II, who were scheduled for lower limb
orthopedic surgeries. Patients were randomly allocated in two groups and were given following drug
intrathecally as per group. Group BM – bupivacaine 15 mg(0.5% heavy) with magnesium sulphate (100 mg)
Group B – bupivacaine 15 mg (0.5% heavy) with 0.5 ml normal saline. Parameters monitored were onset of
sensory and motor block, duration of analgesia, hemodynamic parameters, sedation score and intra and
postoperative complication. Data analyzed by student’s t test and chi square test.
Results: The time of onset of sensory block was comparable in both the group, the time of onset of motor block
was delayed in group BM (77.37 ± 8.69) compared to Group B (72.50 ± 12.40). The mean duration of motor
blockade was 322.25 ± 23.91 min in group BM and 272.50 ± 23.01 min in group B. It was statistically
significant. The postoperative analgesia was found to be prolonged with addition of intrathecal magnesium
sulphate (24 hr VAS score 2.13 ± 1.17 in BM group, and 3.40 ± 1.79 in Group B) and it provided better
hemodynamic stability.
Conclusion: The addition of 100 mg of magnesium sulfate to hyperbaric bupivacaine has effectively extended
analgesia duration, influenced motor blockade onset, and improved hemodynamic stability without notable
adverse effects, making it a valuable adjunct in lower limb orthopedic postoperative pain management.
Additional research and trials are warranted to fully understand its therapeutic benefits and optimize its clinical
utility
Abstract (English)
Abstract
Background and Aim: Intrathecal adjuvants have gained popularity for prolonging duration and quality of
subarachnoid block. Hence, this study was undertaken to evaluate the effect of addition of magnesium sulphate
with bupivacaine (hyperbaric) in spinal anesthesia for prolongation of analgesia.
Material and Methods: This randomized controlled study enrolled 80 patients, comprising both males and
females with American Society of Anesthesiologists physical status I or II, who were scheduled for lower limb
orthopedic surgeries. Patients were randomly allocated in two groups and were given following drug
intrathecally as per group. Group BM – bupivacaine 15 mg(0.5% heavy) with magnesium sulphate (100 mg)
Group B – bupivacaine 15 mg (0.5% heavy) with 0.5 ml normal saline. Parameters monitored were onset of
sensory and motor block, duration of analgesia, hemodynamic parameters, sedation score and intra and
postoperative complication. Data analyzed by student’s t test and chi square test.
Results: The time of onset of sensory block was comparable in both the group, the time of onset of motor block
was delayed in group BM (77.37 ± 8.69) compared to Group B (72.50 ± 12.40). The mean duration of motor
blockade was 322.25 ± 23.91 min in group BM and 272.50 ± 23.01 min in group B. It was statistically
significant. The postoperative analgesia was found to be prolonged with addition of intrathecal magnesium
sulphate (24 hr VAS score 2.13 ± 1.17 in BM group, and 3.40 ± 1.79 in Group B) and it provided better
hemodynamic stability.
Conclusion: The addition of 100 mg of magnesium sulfate to hyperbaric bupivacaine has effectively extended
analgesia duration, influenced motor blockade onset, and improved hemodynamic stability without notable
adverse effects, making it a valuable adjunct in lower limb orthopedic postoperative pain management.
Additional research and trials are warranted to fully understand its therapeutic benefits and optimize its clinical
utility
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IJCPR,Vol16,Issue5,Article33.pdf
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Additional details
Dates
- Accepted
-
2024-05-23