scholarly journals COMPARISON OF INTRATHECAL HYPERBARIC ROPIVACAINE 0.5% WITH AND WITHOUT 75 MG MAGNESIUM SULFATE AS AN ADJUVANT FOR INFRA UMBILICAL SURGERIES: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL

2021 ◽  
pp. 117-121
Author(s):  
SRINIDHI SRIKANTH ◽  
ANTONY JOHN CHARLES S ◽  
YASHA KAMAESHAR ◽  
GAYATRI MISHRA
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Magnesium Sulfate ◽  
Statistical Tests ◽  
Total Duration ◽  
Motor Blockade ◽  
Double Blind ◽  
Sensory Blockade ◽  
Free Interval ◽  
Post Operative Pain

Objective: Intrathecal magnesium as an adjuvant to hyperbaric ropivacaine could extend duration of sensory blockade and improve the quality of post-operative analgesia; thereby reducing opioid requirements and its adverse effects. Hence, we conducted this prospective, randomized, double-blind clinical trial to observe its effects for day care surgeries. Methods: After obtaining institutional ethical committee approval and registration of trial, patients’ informed consent was taken and eighty adult patients of either gender, ASA 1 and 2, posted for infra umbilical surgeries were divided into two groups: Group RM received 3 ml hyperbaric Ropivacaine with 0.75 ml magnesium sulfate (75 mg) and Group R received 3 ml hyperbaric Ropivacaine with 0.75 ml sterile water. Sensory and motor blockade parameters, hemodynamic variables, and adverse effects were monitored, analyzed using appropriate statistical tests. Results: Total duration of sensory blockade was significantly prolonged in Group RM compared to Group R (242.8 ± 9.9 versus 186.6 ± 8.4 min) (***p<0.001). Complete motor regression was observed significantly earlier in Group RM than in Group R (151.3 ± 7.8 versus 184.7 ± 5.6 min) (*p<0.05). Post-operative pain free interval was significantly prolonged in group RM compared to group R (725.2 ± 18.6 vs. 515.2 ± 17.8 min) (***p<0.001). Conclusion: We concluded that intrathecal magnesium as an adjuvant to hyperbaric Ropivacaine significantly prolonged both sensory blockade duration, post-operative pain-free interval without increasing motor blockade duration and the incidence of adverse effects.

scholarly journals Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

2016 ◽  
Vol 1 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Naina P Dalvi ◽  
Narendra Patil
Keyword(s):  
Blood Pressure ◽  
Postoperative Analgesia ◽  
Total Duration ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Prolonged Duration ◽  
American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

scholarly journals Comparative study of ropivacaine with ropivacaine-fentanyl and ropivacaine-fentanyl- magnesium sulfate in epidural anesthesia for lower limb surgeries

2018 ◽  
Vol 5 (4) ◽  
pp. 1300 ◽  
Author(s):  
Arushi Gupta ◽  
Tanmay Tiwari ◽  
Rajni Kapoor ◽  
Anita Malik ◽  
Haider Abbas ◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Epidural Anesthesia ◽  
Normal Saline ◽  
Lower Limb ◽  
Quality Care ◽  
Complete Recovery ◽  
Motor Blockade ◽  
Double Blind ◽  
Sensory Blockade ◽  
Anesthetic Drugs

Background: Epidural anesthesia is currently one of the most used technique for patients undergoing lower limb surgery. Dose sparing action of one adjuvant for another in epidural anesthesia with local anesthetic drugs for providing quality care to the patient remains controversial. Aims of the present study was to compare and study the properties 0.75% Ropivacaine alone (R) with 0.75% Ropivacaine-Fentanyl (RF) and 0.75% Ropivacaine-Fentanyl-Magnesium sulfate (RFM) in epidural anesthesia for lower limb surgeries. Study design was prospective randomized double blind study.Methods: Patients between 18-60 years of age of ASA physical status class I and II undergoing lower limb surgeries were randomly allocated into 3 groups of 20 each. Total volume in epidural space given was 17ml in all 3 groups. Group R (n=20) received 15ml of 0.75% Ropivacaine with 2ml of normal saline, Group RF (n=20) received 15ml of 0.75% Ropivacaine with 50mg of fentanyl (1ml) and 1ml normal saline and Group RFM (n=20) received 15ml of 0.75% Ropivacaine with 50mg of fentanyl (1ml) and 100mg MgSO4 (1ml). Patients were then studied for hemodynamic profile, various block characteristics and side effects. Statistical analysis used was ANOVA, paired t-test, Chi-square and post hoc test were used. P <0.05 was considered significant.Results: All three groups had stable hemodynamic parameters with Group RFM showing better block characteristics (p <0.001) in terms of time for achieving onset of analgesia, time for achieving T10 sensory blockade, time for requirement of first epidural top up, time for achieving motor Blockade, time for complete recovery of motor blockade with no significant differences in the side effect profile.Conclusions: Epidural anesthesia for lower limb surgeries may have better block characteristic parameters if a combination of Ropivacaine-fentanyl-magnesium sulphate is used in comparison with ropivacaine-fentanyl or ropivacaine alone.

scholarly journals An Investigation Into the Effects of Magnesium Sulfate on the Complications of Succinylcholine Administration in Nulliparous Women Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial

2019 ◽  
Vol 7 (4) ◽  
pp. 520-525
Author(s):  
Davoud Aghamohamadi ◽  
Mehdi Khanbabayi Gol
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Magnesium Sulfate ◽  
Statistical Tests ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Nulliparous Women ◽  
Double Blind Clinical Trial ◽  
Significant Difference ◽  
Elective Cesarean

Objectives: Controlling the complications of anesthetics (e.g., succinylcholine) seems necessary since they are greater for nulliparous women who undergo elective cesarean section (C-section). The present study aimed to investigate the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective C-section. Materials and Methods: This double-blind clinical trial was conducted on 60 nulliparous women during 2012-2013. The women were randomly assigned to A and B groups. Before inducing the rapid anesthesia with succinylcholine, patients in the intervention group received 30 mg/kg of magnesium sulfate within 10 minutes and then the hemodynamic status and the side effects of succinylcholine were recorded in a special form. Statistical tests were performed using repeated-measures ANOVA, chi-square test, and one-way ANOVA tests and the level of significance was determined to be P<0.05. Results: There was no significant difference between the two groups in terms of demographic data (P>0.059). However, the results indicated that there was a significant difference between the 2 groups regarding the myoglobin level (P=0.010). Contrarily, the results showed that most patients in the intervention (n=23) and control (n=15) groups experienced no or mild and severe fasciculation, respectively (P<0.001). Conclusions: In general, magnesium sulfate can greatly control and reduce the complications of succinylcholine administration, including fasciculation.

scholarly journals The Opioid Analgesic Reduction Study (OARS): A Comparison of Opioid vs. Non-Opioid Combination Analgesics for Management of Post-Surgical Pain Study Protocol for a Double-Blind Randomized Multi-Center Clinical Trial

2021 ◽  
Author(s):  
Cecile A. Feldman ◽  
Janine Fredericks-Younger ◽  
Shou-En Lu ◽  
Paul J. Desjardins ◽  
Hans Malmstrom ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Pain Management ◽  
Opioid Analgesic ◽  
Third Molar ◽  
The United States ◽  
Double Blind ◽  
Post Operative Pain ◽  
Decision Making Tool ◽  
Molar Extraction

Abstract Background: Everyday people die unnecessarily from opioid overdose-related addiction. Dentists are among the leading prescribers of opioid analgesics. Opioid seeking behaviors have been linked to receipt of initial opioid prescriptions following the common dental procedure of third molar extraction. With each opioid prescription a patient’s risk for opioid misuse or abuse increases. With an estimated 56 million tablets of 5 mg hydrocodone annually prescribed after third molar extractions in the United States, 3.5 million young adults may be unnecessarily exposed to opioids by dentists who are inadvertently increasing their patient’s risk for addiction.Methods: A double blind, stratified randomized, multi-center clinical trial has been designed to evaluate whether a combination of over-the-counter non-opioid containing analgesics is not inferior to the most prescribed opioid analgesic. The impacted 3rd molar extraction model is being used due to the predictable severity of the post-operative pain and generalizability of results. Within each site/clinic and gender type (male/female), patients are randomized to receive either OPIOID (hydrocodone/acetaminophen 5/300 mg) or NON-OPIOID (ibuprofen/acetaminophen 400/500 mg). Outcome data include pain levels, adverse events, overall patient satisfaction, ability to sleep, and ability to perform daily functions. To develop clinical guidelines and a clinical decision making tool, pain management, extraction difficulty and number of tablets taken is being collected enabling an experimental decision making tool to be developed. Discussion: The proposed methods address the short comings of other analgesic studies. Although prior studies have tested short-term effects of single doses of pain medications, patients and their dentists are interested in managing pain for the entire post-operative period, not just the first 12 hours. After surgery, patients expect to be able to perform normal daily functions without feeling nauseous or dizzy and they desire a restful sleep at night. Parents of young people are concerned with the risks of opioid use and misuse, either related to treatments received or to subsequent use of leftover pills. Upon successful completion of this clinical trial, dentists, patients, and their families will be better able to make informed decisions regarding post-operative pain management.Trial registration: ClinicalTrials.gov NCT04452344. Registered on June 20, 2020

scholarly journals Lumbar Intrathecal Administration of the Quaternary Lidocaine Derivative, QX-314, Produces Irritation and Death in Mice

2010 ◽  
Vol 113 (2) ◽  
pp. 438-444 ◽  
Author(s):  
Stephan K. W. Schwarz ◽  
Helen M.-C. Cheung ◽  
Craig R. Ries ◽  
Sang Mook Lee ◽  
Jimmy T. C. Wang ◽  
...  
Keyword(s):  
Treatment Group ◽  
Adverse Effects ◽  
Intrathecal Administration ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Suitable Candidate ◽  
Neural Blockade ◽  
Normal Behavior ◽  
Blinded Study ◽  
Positive Controls

Background We recently found that peripheral administration of the quaternary lidocaine derivative, QX-314, produces long-lasting sensory and motor blockade in animals. The goal of this study was to test whether intrathecal QX-314 has similar properties. Methods We conducted a randomized, double-controlled, blinded study with female CD-1 mice. Animals in the treatment group received lumbar intrathecal QX-314 (0.5-10 mM; volume, 2 microl; each concentration, n = 6). Normal saline and lidocaine (70 mM) served as negative and positive controls (each group, n = 12), respectively. Animals were tested for up to 3 h for lumbosacral neural blockade and observed for adverse effects. Results No animal injected with saline and 11 of 12 (92%) animals injected with lidocaine displayed reversible lumbosacral motor blockade (P &lt; 0.001). QX-314 (5 mM) produced motor blockade in four of the six (67%) and sensory blockade in five of the six animals (83%; P &lt; 0.05 vs. saline). However, six of the six mice (100%) at 5 mM QX-314 and five of the six (83%) at 10 mM exhibited marked irritation; one of the six animals at 5 mM (17%) and two of the six at 10 mM (33%) died. We observed no neural blockade without adverse effects in any animal injected with QX-314. All animals injected with saline and 11 of the 12 (92%) animals injected with lidocaine demonstrated normal behavior. Conclusion Lumbar intrathecal QX-314 concentration-dependently produced irritation and death in mice, at lower concentrations than those associated with robust motor blockade. Although QX-314 did produce long-lasting neural blockade, these findings indicate that QX-314 is unlikely to be a suitable candidate for spinal anesthesia in humans.

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