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Clinical Investigations

A randomized controlled trial to evaluate the effect of addition of epidural magnesium sulphate on the duration of postoperative analgesia in patients undergoing lower abdominal surgeries under epidural anaesthesia

Authors:

Anju Gupta ,

IN
About Anju

Specialist grade II,

Anaesthesiology,
ESI Hospital ,
Okhala
New Delhi

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Vipin Kumar Goyal,

IN
About Vipin

Senior Resident, Department of Anaesthesiology

MAMC and associated hospital, New Delhi

 

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Nishkarsh Gupta,

IN
About Nishkarsh

Assistant Professor, Anesthesiology

Dr BRA IRCH, AIIMS, New Delhi

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Rajesh Mane,

IN
About Rajesh

Professor, Anaesthesiology

JN medical college, KLE’s university, Belgaum, Karnataka.

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Manju Nath C Patil

IN
About Manju

Associate Professor, Anaesthesiology

JN medical college, KLE’s university, Belgaum, Karnataka.

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Abstract

Abstract:

Background: Noxious stimuli release excitatory neurotransmitters such as glutamate and aspartate, which bind to various receptors including N-methyl-D-aspartate (NMDA) receptors. Magnesium is a NMDA antagonist and has antinociceptive effects in animal and human models of pain. The addition of magnesium to postoperative epidural infusion may decrease postoperative pain and requirement of opioids.

 

Methods:  Sixty patients undergoing elective total abdominal hysterectomies were enrolled to receive either 1ml of magnesium sulfate (50 mg/ml) (Group M) or 1 ml of saline (Group C) in the epidural anaesthetic solution (9ml of 0.125% bupivacaine) for postoperative analgesia. Fentanyl 1µg/kg was given epidurally as rescue analgesia. Haemodynamic parameters, pain assessment using a visual analogue scale (VAS), and fentanyl consumption were recorded in the postoperative period.

 

Results: There was significant difference between groups in the time to first analgesic requirement. Compared with Group C, patients in Group M received smaller doses of epidural fentanyl (P< 0.001). The cumulative fentanyl consumption in 24 h was significantly lower in Group M (119±56 mg) as compared to  Group C(267.8± 92 mg)(P < 0.001). Patients in Group M had less pain as measured via VAS score in the first hour of the postoperative period (P < 0.001). The groups were similar with respect to haemodynamic and respiratory variables, sedation, pruritus, and nausea.

Conclusion: Administration of magnesium to epidural local anaesthetic solution provides longer duration of postoperative analgesia and reduced postoperative fentanyl consumption without added side-effects.

DOI: http://dx.doi.org/10.4038/slja.v21i1.4435

DOI: http://doi.org/10.4038/slja.v21i1.4435
How to Cite: Gupta, A. et al., (2013). A randomized controlled trial to evaluate the effect of addition of epidural magnesium sulphate on the duration of postoperative analgesia in patients undergoing lower abdominal surgeries under epidural anaesthesia. Sri Lankan Journal of Anaesthesiology. 21(1), pp.27–31. DOI: http://doi.org/10.4038/slja.v21i1.4435
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Published on 21 Feb 2013.
Peer Reviewed

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