Evaluation of analgesia by epidural Fentanyl and MgSO4 with Fentanyl for postoperative analgesia in patients of lower abdominal surgeries
A comparative study
Keywords:
fentanyl, magnesium sulphate, epidural anaesthesia, hemodynamicsAbstract
Background: The addition of Magnesium sulphate (MgSO4) to postoperative Fentanyl Epidural infusions has been demonstrated to reduce the requirement for Fentanyl. Methodology: Group I (38 patients) got Epidural Fentanyl 50 mg (1 cc) diluted and made up to 6 cc with normal saline, whereas Group II (38 patients) received Epidural Fentanyl 50 μg (1 cc) + MgSO4 50 mg (4 units in insulin syringe of 50% solution) diluted and made up to 6 cc with normal saline. The effects of analgesia on pulse rate and blood pressure were measured as well as the duration of analgesia. Results: In this study, an average age of the study population was 41.25 ± 3.25 years in Group I and 42.14 ± 4.42 years in Group II. The pulse rate in Group-I increased significantly from 105 minutes compared to Group-II, whereas it remained steady in Group-II throughout the research duration. Systolic BP increased significantly in Group-I after 90 minutes compared to Group-II, but remained steady in Group-II. SPO2 and respiratory rates did not differ significantly.Conclusion: Adding magnesium sulphate to fentanyl in epidural analgesia increased the duration of analgesia while maintaining hemodynamic stability.
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Arcioni R, Palmisani S, Tigano S, Santorsola C, Sauli V, Romano S, Mercieri M, Masciangelo R, De Blasi RA, Pinto G. Combined intrathecal and epidural magnesium sulfate supplementation of spinal anesthesia to reduce post‐operative analgesic requirements: a prospective, randomized, double‐blind, controlled trial in patients undergoing major orthopedic surgery. Acta anaesthesiologica scandinavica. 2007;51(4):482-9.
Begon S, Pickering G, Eschalier A, Dubray C. Magnesium increases morphine analgesic effect in different experimental models of pain. The Journal of the American Society of Anesthesiologists. 2002;96(3):627-32.
Bilir AY, Gulec S, Erkan A, Ozcelik AB. Epidural magnesium reduces postoperative analgesic requirement. British journal of anaesthesia. 2007;98(4):519-23.
Buvanendran A, Kroin JS. Useful adjuvants for postoperative pain management. Best practice & research Clinical anaesthesiology. 2007;21(1):31-49.
Dubé L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Canadian journal of anaesthesia. 2003 ;50(7):732-46.
Garg R, Banwait S, Pawar M, Sharma S, Sood R. Evaluation of single epidural bolus dose of magnesium as an adjuvant to epidural fentanyl for postoperative analgesia: a prospective, randomized, double-blind study. Saudi J Anaesth 2012; 6: 273–8.
Garimella V, Cellini C. Postoperative pain control. Clinics in colon and rectal surgery. 2013;26(03):191-6.
Ghatak T, Chandra G, Malik A, Singh D, Bhatia VK. Evaluation of the effect of magnesium sulphate vs. clonidine as adjunct to epidural bupivacaine. Indian journal of anaesthesia. 2010;54(4):308.
Ginosar Y, Riley ET, Angst MS. The site of action of epidural fentanyl in humans: the difference between infusion and bolus administration. Anesthesia & Analgesia. 2003;97(5):1428-38.
Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiology Clinics of North America. 2005;23(1):21-36.
Katz J, Melzack R. Measurement of pain. Surgical Clinics of North America. 1999;79(2):231-52.
Kogler J, Karaman-Ilić M, Hrabač P, Perić M, Bekavac-Mišak V. Effects of epidural magnesium sulphate on intraoperative sufentanil and postoperative analgesic requirements in thoracic surgery patients. Signa vitae: journal for intesive care and emergency medicine. 2016;11(1.):56-73.
McKeown JL. Pain management issues for the geriatric surgical patient. Anesthesiology Clinics. 2015;33(3):563-76.
Pinard AM, Donati F, Martineau R, Denault AY, Taillefer J, Carrier M. Magnesium potentiates neuromuscular blockade with cisatracurium during cardiac surgery. Canadian journal of anaesthesia. 2003;50(2):172-8.
Qian M, Gao F, Liu J, Xu P. Dexmedetomidine versus fentanyl as adjuvants to ropivacaine for epidural anaesthesia: a systematic review and meta‐analysis. International Journal of Clinical Practice. 2021;75(5):e13772.
Rawal N, Holmström B, Crowhurst JA, Van Zundert A. The combined spinal-epidural technique. Anesthesiology Clinics of North America. 2000;18(2):267-95.
Riker RR, Picard JT, Fraser GL. Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients. Critical care medicine. 1999;27(7):1325-9.
Santhisree M, Krishnaprasad P, Sowbhagyalakshmi B, Babji SN. Evaluation of single epidural bolus dose of magnesium sulphate as an adjuvant to fentanyl for postoperative analgesia in orthopaedic hip surgeries. Journal of evolution of medical and dental sciences. 2014;3(27):7581-8.
Shevchuk, V., Vlasova, O., Zaika, V., Morgun, V., & Kaliuzhna, Y. (2022). Psychological and pedagogical support for the quality of life of persons with disabilities. International Journal of Health Sciences, 6(2), 1108–1122. https://doi.org/10.53730/ijhs.v6n2.11330
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864
Widana, I. K., Sumetri, N. W., & Sutapa, I. K. (2018). Effect of improvement on work attitudes and work environment on decreasing occupational pain. International Journal of Life Sciences, 2(3), 86–97. https://doi.org/10.29332/ijls.v2n3.209
Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation; implications for the treatment of post-injury pain hypersensitivity states. Pain. 1991;44(3):293-9.
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