Efecto de infusión continua de magnesio sobre las características de la raquia. Estudio prospectivo
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Effect of continuous magnesium sulfate infusion on spinal block characteristics: A prospective study.
Agrawal A, Agrawal S, Payal AS.
Saudi J Anaesth [serial online] 2014 [cited 2014 Feb 1];8:78-82.
Abstract
Background: Spinal anesthesia is an established mode of anesthesia for lower limb orthopedic surgeries. The limitations of the technique are short duration of action and limited post-operative analgesia. Concomitant use of intravenous infusion of magnesium sulfate may have an effect on the block characteristics and duration of action of intrathecal bupivacaine. Methods: A total of 80 American Society of Anesthesiologists I and II patients, either sex, 20-60 years of age scheduled for elective orthopedic fixation of fracture of long bones of lower limbs under spinal anesthesia were included. Spinal anesthesia administered with 2.5 ml heavy bupivacaine mixed with 10 mcg fentanyl. The groups were then divided to receive an infusion of injection magnesium sulfate 50 mg/kg/h over 15 min followed by 15 mg/kg/h until the end of the surgery (Group M) and 15 ml of Normal Saline over 15 min followed by 100 ml/h until the end of surgery (Group S). Onset, duration of sensory and motor block and amount of post-operative analgesic were noted. Results: A total of 6 patients (Group M) and seven patients (Group S) had inadequate block and excluded from the study. Mean block height was T6. Time required to achieve block height was 8.82 min versus 7.42 min in Groups M and S respectively (P = 0.04). Mean duration of motor block was longer in group M (160.63 ± 17.76 min) compared with Group S (130.12 ± 20.70 min) (P = 0.000). Time for regression of sensory block to T12/L1was 206.88 ± 20.96 min (Group M) and 163.88 ± 15.46 min (Group S) (P = 0.000). Hemodynamic parameters were similar and statistically not significant. Need for first analgesic requirement was after 262.88 ± 21.11 min in group M and 193.25 ± 17.74 min in the group S (P = 0.000). Mean dosage of tramadol needed in first 24 h was less in group M (190 ± 30.38 mg vs. 265 ± 48.30 mg, P = 0.000). Conclusion: Use of intravenous magnesium with spinal anesthesia reduces post-operative pain and analgesic consumption.
Keywords: Intravenous magnesium, post-operative pain, spinal anesthesia
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| Efecto de la infusión i.v. de magnesio durante raquianestesia en cirugía de cadera y su efecto en analgesia postoperatoria. Nuestra experiencia |
Intravenous infusion of magnesium sulphate during subarachnoid anaesthesia in hip surgery and its effect on postoperative analgesia: our experience.
Pastore A, Lanna M, Lombardo N, Policastro C, Iacovazzo C.
Transl Med UniSa. 2013 Jan 4;5:18-21. Print 2013 Jan.
Abstract
The treatment of degenerative hip joint disease involves modern operative techniques and the use of prosthetic devices individualized on each patient. Being a surgery of considerable importance, great attention is always given by the anaesthesiologist to postoperative analgesia. In general, our goal is to limit the doses of NSAIDs, known to be associated with haemostasis interference and alteration of gastrointestinal apparatus; component of our baseline analgesic protocols after arthroplasty is morphine given parenterally. In order to steadily improve analgesic techniques, which directly impact on patient outcome, we experimented the use of a continuous infusion of magnesium sulphate during subarachnoid anaesthesia. Magnesiumsulphate is the drug of choice in case of eclampsia, and pre-eclampsia (for the risk of evolution in eclampsia). According to the most recent findings, this drug has also analgesic properties: its use as an adjunct to analgesia is based on a non-competitive antagonism towards the NMDA receptor and on the blocking of calcium channels: these properties prevent the mechanisms of central sensitization due to nociceptive stimulation of peripheral nerves.
KEYWORDS:Hip Arthroplasty, Magnesium Sulphate, Postoperative Analgesia, Postoperative Pain, Spinal Anaesthesia
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Infusión perioperatoria de magnesio i.v. y dolor postoperatorio: un meta-análisis
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Peri-operative intravenous administration of magnesium sulphate and postoperative pain: a meta-analysis.
Albrecht E, Kirkham KR, Liu SS, Brull R.
Anaesthesia. 2013 Jan;68(1):79-90. doi: 10.1111/j.1365-2044.2012.07335.x. Epub 2012 Nov 1.
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org |
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