scholarly journals Effect of IV Infusion of Magnesium Sulfate on Postoperative Pain after Spinal Anesthesia: A Prospective Randomized Trial

2021 ◽  
Author(s):  
Shubhi Singhal ◽  
Devang Bharti ◽  
Sangeeta Yadav ◽  
Nitin Hayaran
Keyword(s):  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Lower Limb ◽  
Controlled Study ◽  
Control Group ◽  
Analgesic Requirement ◽  
Group I ◽  
Significant Difference ◽  
Vas Scores

Background: The current study attempts to evaluate the effect of intravenous (IV) infusion of magnesium sulfate during spinal anesthesia on postoperative pain and postoperative analgesic requirements in lower limb surgeries. Methods: In this double blind, randomized controlled study, 60 patients undergoing elective lower limb surgeries, were selected and randomly divided into two groups. Group I received isotonic saline and group II was administered magnesium sulfate 50 mg Kg-1 IV for 15 min and then 15 mg Kg-1 h-1 by continuous IV infusion till the end of surgery or 2 hours, whichever was earlier. Ramsay sedation scores, VAS scores for pain, time of first administration of rescue analgesic and total analgesic requirement were noted in both the groups. Results: Statistically significant difference was observed in the VAS score between the two groups at 1st, 2nd, 3rd, 6th, 9th and 12th hour intervals; with VAS scores being lower in the magnesium group (p<0.05). The mean time of first rescue analgesic requirement in control group was 144.00 mins, while in magnesium group was 246.00 mins (p<0.05). The total rescue analgesic requirement was found to be 251.67 mg and 181.67 mg at the end of 24 hours, in control and magnesium groups, respectively (p<0.05). Conclusion: This study demonstrates statistically significant lowering of postoperative VAS scores, delayed need of postoperative analgesia and reduced total postoperative analgesic requirement in patients receiving intraoperative IV magnesium sulfate compared to the control group. Magnesium sulfate did not cause sedation or any other significant adverse effect in the doses used in the study.

Effect of Magnesium Sulfate on the Total Anesthetic and Analgesic Requirements in Neurosurgery

2021 ◽  
pp. 27-28
Author(s):  
Essam Manaa
Keyword(s):  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Recovery Time ◽  
Control Group ◽  
Double Blind Study ◽  
Clinical Parameters ◽  
Hemodynamic Parameters ◽  
Analgesic Requirement ◽  
Group I ◽  
Significant Difference

Introduction: The intraoperative anesthetic and postoperative analgesic requirements are of great importance especially in neurosurgical anesthesia. This requires balancing a deep and effective anesthesia and postoperative analgesia versus the risks of delayed recovery and postoperative respiratory depression from excessive analgesics. Magnesium sulfate is an antagonist of the N-Methyl-D-Aspartate (NMDA) receptors in a voltage-dependent fashion. Propofol also inhibits the NMDA subtype of the glutamate receptor. Therefore, magnesium sulfate when coadministered with propofol potentiates anesthetic effect and NMDA antagonism of propofol. Majority of the studies that evaluated the anesthetic and analgesic requirement in patients receiving magnesium sulfate depended on the clinical parameters, for example, hemodynamic parameters and measurement of pain scores. In this study, we added bispectral index (BIS) and neuromuscular monitoring using train-of-four (TOF) to adjust intraoperative anesthetic requirements in addition to the clinical parameters. Methodology: This randomized controlled double-blind study included 50 adult ASA I and II male and female patients undergoing neurosurgical maneuvers. Patients were randomly divided into two equal groups. Routine intraoperative monitoring including invasive BP and in addition TOF and BIS were applied. In a blind fashion, patient in group I (Magnesium group) received magnesium sulfate 20 mg/kg as bolus dose over 5 min followed by 0.1 ml/kg/hr of 10% solution as infusion, while patient in group II (Control group) received saline with the same bolus and infusion rates after the induction of anesthesia. Anesthesia was induced in both groups by fentanyl 2 µg/kg, propofol 1.5–2 mg/kg, and rocuronium in a dose of 0.6 mg/kg to facilitate ETT insertion. This is followed by continuous infusion of propofol 6–10 mg/kg/hr and fentanyl 1–2 mic/kg/hr. The parameters which were assessed included hemodynamic parameters (HR and BP), TOF, and BIS. Total consumptions of propofol, fentanyl, rocuronium, and postoperative analgesic requirements (PCA morphine) were recorded. In addition, recovery time and postoperative pain score by visual analog scale (VAS) were recorded. Result: There was no significant difference in patient characteristics between the two groups. As regard the hemodynamic changes and BIS, no significant difference was seen between the two groups except the HR change which was significantly reduced (p = 0.005) with surgical stimulation in group I compared to the other group. Results also showed that the mean fentanyl, propofol, and rocuronium consumption, recovery time, degree of postoperative pain, and postoperative analgesic requirements were significantly less in patients that received magnesium sulfate infusion compared to those in the control group. Conclusion: Magnesium sulfate is most likely a safe and cost-effective supplement to the general anesthesia in neurosurgery as it reduces the total anesthetic and analgesic requirements and postoperative pain.

scholarly journals Antinociceptive effects of magnesium sulfate for monitored anesthesia care during hysteroscopy: a randomized controlled study

2020 ◽  
Author(s):  
Peng-fei Gao ◽  
Jing-yan Lin ◽  
Shun Wang ◽  
Yun-feng Zhang ◽  
Guo-qiang Wang ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Isotonic Saline ◽  
Controlled Study ◽  
Control Group ◽  
Anesthesia Induction ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Significant Difference

Abstract Background: Opioids are the most effective antinociceptive agents, they have undesirable side effects such as respiratory depressant and postoperative nausea and vomiting. The purpose of the study was to evaluate the antinociceptive efficacy of adjuvant magnesium sulphate to reduce intraoperative and postoperative opioids requirements and their related side effects during hysteroscopy.Methods: 70 patients scheduled for hysteroscopy were randomly divided into 2 groups. Patients in the magnesium group (Group M) received intravenous magnesium sulfate 50 mg/kg in 100 ml of isotonic saline over 15 min before anesthesia induction and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group (Group C) received an equal volume of isotonic saline as placebo. All patients were anesthetized under a BIS guided monitored anesthesia care with propofol and fentanyl. Intraoperative hemodynamic variables were recorded and postoperative pain scores were assessed with verbal numerical rating scale (VNRS) 1 min, 15 min, 30 min, 1 hour, and 4 hours after recovery of consciousness. The primary outcome of our study was total amount of intraoperative and postoperative analgesics administered.Results: Postoperative serum magnesium concentrations in Group C were significantly decreased than preoperative levels (0.86 ± 0.06 to 0.80 ± 0.08 mmol/L, P=0.001) while there was no statistical change in Group M (0.86 ± 0.07 to 0.89 ± 0.07 mmol/L, P=0.129). Bradycardia did not occur in either group and the incidence of hypotension was comparable between the two groups. Total dose of fentanyl given to patients in Group M was less than the one administered to Group C [100 (75-150) vs 145 (75-175) μg, median (range); P < 0.001]. There was no statistically significant difference for patients who needed rescue analgesic between the two groups [14 vs 6 subjects in Group C and Group M, RR=0.44 (0.19 to 1.01), P=0.052, NNT 4.349]. In addition, patients receiving magnesium displayed lower VNRS scores at 15 min, 30 min, 1 hour, and 4 hours postoperatively. Conclusions: In hysteroscopy, adjuvant magnesium administration is beneficial to reduce intraoperative fentanyl requirement and postoperative pain without cardiovascular side effects. Our study indicates that if surgical patients have risk factors for hypomagnesemia, assessing and correcting magnesium level will be necessary.Trial registration: www.chictr.org.cn ChiCTR1900024596 date of registration: July 18th 2019.

Evaluation of red cell distribution width (RDW) as a septic marker in comparison with clinical scores and C-reactive protein

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali Ahmed Naga ◽  
Mohammed Ismaeil Abdel Fattah ◽  
Walid Hamed Nofal ◽  
Mohammed Abd-elsalam AlMenshawe
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Distribution Width ◽  
Clinical Scores ◽  
Group I ◽  
Significant Difference ◽  
Sepsis And Septic Shock

Abstract Background Challenges of diagnosing and treating sepsis only seem more difficult as incidence increases, patients become older and sicker, and pathogenic organisms evolve. New understanding of inflammatory mediators and pathways, immunity, and genetic variability in this disease state suggests that the current definitions of SIRS, sepsis, severe sepsis, and septic shock are oversimplified. Objective The aim of our study is to evaluate the level of RDW, CRP and clinical scores "SOFA and APACHI" as markers in patients with sepsis and their levels on the outcome and resolution of sepsis in ICU. Methodology We conducted a prospective observational controlled study on 90 adult persons of both sex, 45 of them are adult patients and served as the study group (Group I), and the other 45 are healthy adult volunteers and served as the control group (Group II). The study group represented patients admitted to the ICU of Intensive Care Unit at Damanhour Medical National Institute who fulfilled the diagnostic criteria for sepsis, severe sepsis and septic shock on arrival to ICU according to the SCCM/ ESICM/ ACCP/ ATS/SIS International Sepsis Definitions Conference. Results. In the present study we found that CRP measured on admission was not a predictor of mortality, while that measured at day 5 and day 10 predicted mortality, where there was no statistically significant difference in CRP levels between survivors and non-survivors at the day of admission while there were statistically significant differences between survivors and non survivors according to CRP levels at day 5 (p = 0.001*) and at day 10 (p = 0.001*). It was found also that there were statistically significant differences between survivors and non-survivors according to RDW at day 1(p = 0.011*) and at day 5(p = 0.009*), at day 10 was found there was no statistically significant difference between survivors and non-survivors (p = 0.338). Conclusion RDW is a new promising cheap and readily available biomarker that can be able to diagnose patients with sepsis with accuracy comparable to CRP. Also, RDW at admission is able to predict mortality.

scholarly journals Clinical Efficacy of Ultrasound-Mediated Transdermal Lidocaine and Capsaicin Delivery for the Treatment of Allodynia Caused by Herpes Zoster

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3739-3746
Author(s):  
Yue-e Dai ◽  
Shao-Xing Liu ◽  
Ling Ye ◽  
Yun-Xia Zuo
Keyword(s):  
Drug Delivery ◽  
Herpes Zoster ◽  
Adverse Events ◽  
Emotional Functioning ◽  
Final Analysis ◽  
Intradermal Injection ◽  
Controlled Study ◽  
Control Group ◽  
Group I ◽  
Vas Scores

Abstract Objective To investigate the efficacy of ultrasound-mediated drug delivery for allodynia caused by herpes zoster. Design Unblinded randomized controlled study with two treatment groups and an additional control group. Subjects Patients hospitalized with allodynia caused by herpes zoster were enrolled. Methods Patients were randomly assigned to three groups: ultrasound-mediated transdermal drug delivery (group U), lidocaine intradermal injection (group I), or control group (group C). The primary outcome was pain intensity associated with allodynia, assessed with the visual analog scale (VAS) while brushing the skin with clothing after treatment stimulated allodynia. The secondary outcomes included an emotional functioning score (ES), average gabapentin consumption, and incidence of adverse events of each group. Results Sixty patients were enrolled in the study, but two of them failed to complete the treatment process. Therefore, 58 patients were included in the final analysis. All groups had lower VAS and ES scores after treatment compared with baseline. The VAS scores in groups U and I decreased significantly more than in group C (P &lt; 0.05). Mean VAS scores in group U on days 1, 2, and 3 were lower than in group C (P &lt; 0.01). ES was significantly lower in group U compared with groups I and C after treatment (P &lt; 0.001). Average gabapentin consumption and incidence of adverse events in group C were higher than in the other two groups. Conclusions In this study of treatment of allodynia caused by herpetic zoster, ultrasound-mediated lidocaine and capsaicin delivery provided better pain relief and improved emotional functioning compared with intradermal blockade with local anesthetics.

scholarly journals The relations between the level of Mu-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Postoperative Pain ◽  
Opioid Receptor ◽  
Control Group ◽  
Pain Level ◽  
Analgesic Requirement ◽  
Receptor Level ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use ◽  
Μ Opioid Receptors

Abstract Background In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24 th hours in postoperative period. Results Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group. Conclusions In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.

scholarly journals COMPARATIVE STUDY OF INTRATHECAL FENTANYL WITH HYPERBARIC BUPIVACAINE TO IMPROVE PERIOPERATIVE ANALGESIA IN PATIENT UNDERGOING ORTHOPEDIC SURGERY

2021 ◽  
pp. 55-58
Author(s):  
Rahul Wagh ◽  
Swapnil Sangale ◽  
Nagesh Jambure
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Study Group ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Various methods exist for treating post-operative pain which includes systemic narcotics, NSAIDS, patient-controlled analgesia, regional anaesthesia techniques, epidural local anaesthetic – narcotic mixtures, cryoanalgesia, transcutaneous electric nerve stimulation, psychological methods. Various opioides intrathecally and epidurally have been tried for post-operative analgesia. These include - morphine, pethidine, pentazocine, methadone, tramadol, Fentanyl, sufentanyl. In present study, we tried to find out analgesic effectiveness of intrathecal Fentanyl for post-operative analgesia, combined with 0.5 % Bupivacaine and side effects if any, in patients undergoing lower limb surgeries. Materials and Methods: After approval from the local ethics committee and with written informed consent from patient, a randomized controlled prospective study is carried out in the medical college and hospital.100 patients belonging to American Society of Anesthesiologists (ASA)classification I &amp; II, aged between 18-60 years, posted for elective lower limb surgeries, were randomly allocated for the study. Group-I: 50 patients received intrathecal 3 ml of 0.5 % hyperbaric Bupivacaine only. Group-II : 50 patients received intrathecal 3 ml of 0.5% hyperbaric Bupivacaine and Fentanyl 25 mcg.The patients studied across the group did not vary much with respect to age,height, weight and sex distribution. Results: The onset of sensory blockade was faster by 1.27 min in Group-BF. The perioperative and postoperative hemodynamic parameters were comparable in both the groups. The sensory analgesia in Group II was significantly prolonged by 159 mins, thus increasing the duration of analgesia. The time of first request of analgesics by the patients in group-II is prolonged compared to group-I thus prolonging the duration of analgesia. Analgesic requirement is also reduced in study group in early post-operative period. The onset of motor block was faster when Fentanyl was added to intrathecal Bupivacaine and it was 1.1 min earlier in study group. The duration of motor block to Bromage III was prolonged by almost 22 min in study group as compare to control group. Visual analogue scores were significantly lower in group-II compared to group-I after two hours of surgery thus reducing the frequency of supplemental postoperative analgesics. Conclusion: With the present study we can summarize that intrathecal Fentanyl potentiates the action of Bupivacaine thereby bringing about better quality and longer duration of analgesia, intense motor block, no hemodynamic disturbance and better postoperative outcome with/ minimum side effects.

scholarly journals Antinociceptive effects of magnesium sulfate for monitored anesthesia care during hysteroscopy: a randomized controlled study

2020 ◽  
Author(s):  
Peng-fei Gao ◽  
Jing-yan Lin ◽  
Shun Wang ◽  
Yun-feng Zhang ◽  
Guo-qiang Wang ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Rating Scale ◽  
Isotonic Saline ◽  
Controlled Study ◽  
Control Group ◽  
Anesthesia Induction ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care

Abstract Background: Opioids are the most effective antinociceptive agents, they have undesirable side effects such as respiratory depressant and postoperative nausea and vomiting. The purpose of the study was to evaluate the antinociceptive efficacy of adjuvant magnesium sulphate to reduce intraoperative and postoperative opioids requirements and their related side effects during hysteroscopy.Methods: 70 patients scheduled for hysteroscopy were randomly divided into 2 groups. Patients in the magnesium group (Group M) received intravenous magnesium sulfate 50 mg/kg in 100 ml of isotonic saline over 15 min before anesthesia induction and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group (Group C) received an equal volume of isotonic saline as placebo. All patients were anesthetized under a BIS guided monitored anesthesia care with propofol and fentanyl. Intraoperative hemodynamic variables were recorded and postoperative pain scores were assessed with verbal numerical rating scale (VNRS) 1 min, 15 min, 30 min, 1 hour, and 4 hours after recovery of consciousness. The primary outcome of our study was total amount of intraoperative and postoperative analgesics administered.Results: Postoperative serum magnesium concentrations in Group C were significantly decreased than preoperative levels (0.86 ± 0.06 to 0.80 ± 0.08 mmol/L, P=0.001) while there was no statistical change in Group M (0.86 ± 0.07 to 0.89 ± 0.07 mmol/L, P=0.129). Bradycardia did not occur in either group and the incidence of hypotension was comparable between the two groups. Total dose of fentanyl given to patients in Group M was less than the one administered to Group C [100 (75-150) vs 145 (75-175) μg, median (range); P < 0.001]. In addition, patients receiving magnesium displayed lower VNRS scores at 15 min, 30 min, 1 hour, and 4 hours postoperatively.Conclusions: In hysteroscopy, adjuvant magnesium administration is beneficial to reduce intraoperative fentanyl requirement and postoperative pain without cardiovascular side effects. Our study indicates that if surgical patients have risk factors for hypomagnesemia, assessing and correcting magnesium level will be necessary.Trial registration: www.chictr.org.cn ChiCTR1900024596. date of registration: July 18th 2019.

scholarly journals Study of leucine-rich alpha-2-glycoprotein-1 marker serum level in cases of malignant epithelial ovarian tumors

2020 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
Abd Elfatah Agameia ◽  
Rania Shafik Swelem ◽  
Hossam Hassan El Sokkary ◽  
Ghada Shehata Elsayed
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Tumor Marker ◽  
Histopathological Examination ◽  
Mean Value ◽  
Ovarian Tumors ◽  
Controlled Study ◽  
Control Group ◽  
Group I ◽  
Significant Difference

Background: The aim of this study was to compare the level of LRG1 in epithelial ovarian cancer (EOC) cases with benign ovarian masses and to evaluate results in relation to CA125.Methods: An observational prospective controlled study was done on 70 patients admitted to El Shatby Maternity University Hospital, Oncology department categorized as follows: study group (group I) included 35 patients, with epithelial ovarian malignancy confirmed by histopathological examination and control group (group Il) included 35 patients with benign ovarian tumors confirmed by histopathological examination. Determination of Serum LRGI level by using enzyme-linked immuno sorbent assay with CA125 tumor marker analysis were done for all cases of both groups.Results: As regard comparison between the two studied groups according to CA125 and LRGI. CA125 in group I ranged from 14.90 to 4600 with a mean value 856.73±1104.03, in group II ranged from 7.45 to 523 with a mean value of 51.97±86.14. LRGI in group I ranged from 62.46 to 653.98 with a mean value of 130.86±119.78, in group Il ranged from 47.73 to 261.78 with a mean value of 77.35±38.75. There was statistically significant difference between the two studied groups regarding CA125 and LRGI (p≤0.05).Conclusions: LRG1 can be used as promising tumor marker to diagnose epithelial malignant ovarian cancer with or without CA125 tumor marker as it was significantly higher in epithelial ovarian cancer patients.

scholarly journals Effect of Preemptive Flurbiprofen Axetil and Tramadol on Transurethral Resection of the Prostate under Spinal Anesthesia

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Jinguo Wang ◽  
Hongqin Li ◽  
Haichun Ma ◽  
Na Wang
Keyword(s):  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Analgesic Requirement ◽  
Flurbiprofen Axetil ◽  
Analgesic Consumption ◽  
Postoperative Time ◽  
Vas Scores ◽  
Group Control Group

Objective. To investigate the efficacy of preoperative intravenous flurbiprofen axetil and tramadol on spinal anesthesia for transurethral resection of the prostate (TURP). Methodology. In this prospective clinical study, we enrolled 60 patients undergoing TURP under spinal anesthesia with small-dose bupivacaine and sufentanil. Patients were randomly divided in two: group flurbiprofen axetil and tramadol (Group FT) intravenously received 1 mg/kg flurbiprofen axetil and 1 mg/kg tramadol 20 min prior to the surgical procedures and group control (Group C) was given normal saline. The characteristics of spinal anesthesia, blood pressure, heart rate, analgesic requirement, visual analogue scale (VAS), and overall satisfaction degree were collected. Results. Time to the first analgesic requirement was significantly longer in Group FT. Patients who needed postoperative analgesics were fewer in Group FT. VAS scores were lower in Group FT at postoperative time points of 1, 2, 6, and 12 h. The patients in Group FT were more satisfied than in Group C. Conclusions. Preoperative flurbiprofen axetil and tramadol can reduce and delay postoperative pain and then decrease analgesic consumption for TURP under spinal anesthesia without an increase of side effects.

scholarly journals Magnesium sulfate intravenous infusion versus intrathecal injection for prevention of post-spinal shivering during lower limb fracture surgery: a randomized controlled study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sherif Abdullah Mohamed ◽  
Nevan Mohamed El Mekawy ◽  
Raed Mohamed Abdelfattah ◽  
Ahmed Ibrahim Abdelkhalik Elsonbaty ◽  
Mohamed Ibrahim Abdelkhalik Elsonbaty
Keyword(s):  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Intrathecal Injection ◽  
Vital Signs ◽  
Controlled Study ◽  
Intravenous Route ◽  
Significant Difference ◽  
Patients At Risk ◽  
Insignificant Difference ◽  
And Control

Abstract Background Shivering is a prevalent adverse event after spinal anesthesia, often disturbing to medical staff and hazardous to patients. Intravenous magnesium sulfate [MgSO4] has been proven to be effective in prevention of post-spinal shivering. However, the risk of intravenous route to develop hypermagnesemia in certain patients encouraged us to do this study in order to investigate the effectiveness of intrathecal MgSO4 as an alternative to the intravenous route in prevention of post-spinal shivering. The enrolled 135 patients were allocated to 3 groups, 45 patients each, groups: intrathecal [T], IV MgSO4 infusion [M], and control [C]. Group T (no. = 45) received 50 mg MgSO4 added to heavy bupivacaine 0.5% intrathecally, while group M (no. = 45) received IV MgSO4 as 50 mg/kg in 100 cc saline within 20 min as a loading dose then infused as 2 mg/kg/h after performing spinal anesthesia. The vital signs, duration and shivering grades, temperature, and adverse effects were recorded. Results T and M groups showed a significant difference from control as regard the incidence of shivering with 40%, 26.7%, and 64.4% for T, M, and C groups, respectively, patients needed rescue pethidine were 17.7%, 11.1%, and 60% for group T, M, and C, respectively, and shivering duration (min) was 24.86 ± 7.411, 20.47 ± 6.61, and 45 ± 36.2 for groups T, M, and C, respectively with a statistically insignificant difference between group T and M as regards these parameters. Conclusions Intrathecal MgSO4 has the potentiality to be used as an alternative to IV route regarding prevention of post-spinal shivering. This makes advantage for intrathecal magnesium use in patients at risk for magnesium toxicity.

Sign in / Sign up

Export Citation Format

Share Document