The Comparison of Preventive Analgesic Effects of Ketamine, Paracetamol and Magnesium Sulfate on Postoperative Pain Control in Patients Undergoing Lower Limb Surgery: A Randomized Clinical Trial

Background: Thoracotomy is one of the most painful surgeries, and failure to alleviate patients' pain can have dangerous consequences. Objectives: This study aimed to evaluate the addition of dexmedetomidine to ropivacaine in the intercostal block for postoperative pain control in patients undergoing thoracotomy. Methods: In this randomized clinical trial, 74 patients aged 18 to 60 years with ASA class I or II, BMI less than 40, and no severe systemic problems referred to a teaching hospital in Ahvaz to undergo thoracotomy were included in the study and randomly divided into two groups. After surgery, an ultrasound-guided intercostal block was done with ropivacaine (5 cc of 0.25% solution; group R) or ropivacaine (5 cc of 0.25% solution) plus dexmedetomidine (0.5 µg/kg; group RD) per dermatome. Two dermatomes above and two dermatomes below the level of surgical incision were used. Pain, total opioid consumption, length of ICU stays, time to first rescue analgesic, and time to get out of bed were compared between the two groups. Results: The intercostal block significantly reduced pain in both groups (P < 0.0001). The pain was lower in the RD group than in the R group from six hours after the intervention up to 24 hours after (P < 0.001). The number of patients who needed rescue analgesia at 12 hours was significantly lower in the RD group (P < 0.05). The RD group also had lower total opioid consumption and a longer time to receive the first rescue analgesia (P < 0.01). There was no significant difference between the two groups in the length of hospitalization and the time to get out of bed. Conclusions: Dexmedetomidine is an effective and safe choice to be used as an adjunct to ropivacaine in ICB, and it extends the duration of analgesia in combination with ropivacaine after thoracotomy.

Download Full-text

Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.2008.01821.x ◽

2008 ◽

Vol 53 (2) ◽

pp. 227-235 ◽

Cited By ~ 79

Author(s):

O. MATHIESEN ◽

M. L. RASMUSSEN ◽

G. DIERKING ◽

K. LECH ◽

K. L. HILSTED ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Randomized Clinical Trial ◽

Pain Control ◽

Abdominal Hysterectomy ◽

Postoperative Pain Control

Download Full-text

The Analgesic Effects of Bupivacaine and Magnesium Sulfate Combination, Bupivacaine, and Adrenaline Combination and Bupivacaine Alone on Post-cesarean Section Pain: A Randomized Clinical Trial

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2021.52 ◽

2018 ◽

Vol 9 (4) ◽

pp. 284-290

Author(s):

Zinatossadat Bouzari ◽

Seyedeh Rabeeh Rouhani ◽

Ebrahim Alijanpour ◽

Shahla Yazdani ◽

Bahman Hasannasab ◽

...

Keyword(s):

Clinical Trial ◽

Cesarean Section ◽

Magnesium Sulfate ◽

Randomized Clinical Trial ◽

Normal Saline ◽

Repeated Measures ◽

The Other ◽

Hemodynamic Parameters ◽

Analgesic Effects ◽

Single Blind

Objectives: The present study was performed to compare the analgesic effects of bupivacaine and magnesium sulfate combination on post-cesarean (C) section pain. Materials and Methods: The present single-blind randomized clinical trial was conducted on 160 C-section candidates. The participants were randomly divided into four groups. When the fascia healed, the first group received 20 mL of 0.25% bupivacaine and the second group received 20 mL of 0.25% bupivacaine combined with subcutaneous adrenaline. In addition, both groups received 50 mL of intravenous normal saline. Further, the third group received subcutaneous bupivacaine and 50 mg/kg of magnesium sulfate and the fourth group received subcutaneous and intravenous normal saline as a placebo. The pain intensity was assessed 2, 6, 12, 18, and 24 hours after spinal anesthesia using the visual analogue scale (VAS) for pain. The dose of pethidine (as a standard analgesic) and hemodynamic parameters (i.e., heart rate [HR] and blood pressure [BP]) was recorded as well. The obtained data were then analyzed utilizing ANOVA, Tukey’s HSD, and repeated measures ANOVA tests. Results: The intensity of pain and the dose of pethidine decreased significantly in the combination of bupivacaine with magnesium compared to the other groups at all times (P < 0.001). However, diastolic BP significantly increased in the bupivacaine + adrenaline group in comparison with the other groups (P = 0.02). Conclusions: Overall, bupivacaine combination with magnesium sulfate is suitable for controlling post-cesarean section pain.

Download Full-text