Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis
Background and Aims: Intrathecal anaesthesia is widely used for infraumbilical surgeries due to its effectiveness in providing pain relief during and after the operation. Adding magnesium sulphate (MgSO4) to intrathecal local anaesthetics can prolong analgesia, reduce postoperative analgesic require...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_862_24 |
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| author | Mohamed Mohamed Belal Osama Mohammad Alazki Mohamed Nabih Bashir Lana Yousef Sbitan Douaa Albelal Farah Albakkar Abdelrahmanh H. Hafez Ayman Issa Nabhan |
| author_facet | Mohamed Mohamed Belal Osama Mohammad Alazki Mohamed Nabih Bashir Lana Yousef Sbitan Douaa Albelal Farah Albakkar Abdelrahmanh H. Hafez Ayman Issa Nabhan |
| author_sort | Mohamed Mohamed Belal |
| collection | DOAJ |
| description | Background and Aims:
Intrathecal anaesthesia is widely used for infraumbilical surgeries due to its effectiveness in providing pain relief during and after the operation. Adding magnesium sulphate (MgSO4) to intrathecal local anaesthetics can prolong analgesia, reduce postoperative analgesic requirements and improve the management of shivering perioperatively. This review aims to investigate the use of intrathecal adjuvant MgSO4 for anaesthesia in infraumbilical surgeries.
Methods:
We performed a meta-analysis (PROSPERO ID: CRD42023432378) of trials, which included patients who underwent a variety of surgical procedures under spinal anaesthesia with intrathecal MgSO4 as an adjuvant to spinal local anaesthetics. The analysed outcomes included sensory and motor effects and adverse effects. We presented dichotomous outcomes as risk ratios with 95% confidence intervals (CI), while continuous outcomes were measured as mean differences (MDs) with 95% CI. We considered the results significant if the P value was < 0.05.
Results:
Thirty-two studies (2379 patients) were included. Adding intrathecal MgSO4 to bupivacaine significantly prolonged the time for regression of two segments from the maximum height (MD: 27.18 min; 95% CI: 12.56, 41.79; P = 0.0003), delayed the onset of sensory block to T10 (MD: 1.93 min; 95% CI: 1.10, 2.77; P < 0.0001), prolonged the duration of motor block (Bromage score = 0) (MD: 15.13 min; 95% CI: 4.59, 25.66; P = 0.005) and extended time for first rescue analgesia (MD: 43.80 min; 95% CI: 26.47, 61.14; P < 0.00001). No significant effect for MgSO4 on side effects was observed.
Conclusion:
Our review underscores intrathecal MgSO4’s benefits in prolonging block duration and improving pain management, but highlights significant heterogeneity, limiting the strength of these findings. |
| format | Article |
| id | doaj-art-ecf5e3cb0c8247ea95da63ae12d8fc6c |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-ecf5e3cb0c8247ea95da63ae12d8fc6c2025-02-06T05:26:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-01-016918610710.4103/ija.ija_862_24Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysisMohamed Mohamed BelalOsama Mohammad AlazkiMohamed Nabih BashirLana Yousef SbitanDouaa AlbelalFarah AlbakkarAbdelrahmanh H. HafezAyman Issa NabhanBackground and Aims: Intrathecal anaesthesia is widely used for infraumbilical surgeries due to its effectiveness in providing pain relief during and after the operation. Adding magnesium sulphate (MgSO4) to intrathecal local anaesthetics can prolong analgesia, reduce postoperative analgesic requirements and improve the management of shivering perioperatively. This review aims to investigate the use of intrathecal adjuvant MgSO4 for anaesthesia in infraumbilical surgeries. Methods: We performed a meta-analysis (PROSPERO ID: CRD42023432378) of trials, which included patients who underwent a variety of surgical procedures under spinal anaesthesia with intrathecal MgSO4 as an adjuvant to spinal local anaesthetics. The analysed outcomes included sensory and motor effects and adverse effects. We presented dichotomous outcomes as risk ratios with 95% confidence intervals (CI), while continuous outcomes were measured as mean differences (MDs) with 95% CI. We considered the results significant if the P value was < 0.05. Results: Thirty-two studies (2379 patients) were included. Adding intrathecal MgSO4 to bupivacaine significantly prolonged the time for regression of two segments from the maximum height (MD: 27.18 min; 95% CI: 12.56, 41.79; P = 0.0003), delayed the onset of sensory block to T10 (MD: 1.93 min; 95% CI: 1.10, 2.77; P < 0.0001), prolonged the duration of motor block (Bromage score = 0) (MD: 15.13 min; 95% CI: 4.59, 25.66; P = 0.005) and extended time for first rescue analgesia (MD: 43.80 min; 95% CI: 26.47, 61.14; P < 0.00001). No significant effect for MgSO4 on side effects was observed. Conclusion: Our review underscores intrathecal MgSO4’s benefits in prolonging block duration and improving pain management, but highlights significant heterogeneity, limiting the strength of these findings.https://journals.lww.com/10.4103/ija.ija_862_24analgesiaintrathecalmagnesium sulphatemeta-analysismotor blockpainsensory blockspinal anaesthesiasurgery |
| spellingShingle | Mohamed Mohamed Belal Osama Mohammad Alazki Mohamed Nabih Bashir Lana Yousef Sbitan Douaa Albelal Farah Albakkar Abdelrahmanh H. Hafez Ayman Issa Nabhan Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis Indian Journal of Anaesthesia analgesia intrathecal magnesium sulphate meta-analysis motor block pain sensory block spinal anaesthesia surgery |
| title | Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis |
| title_full | Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis |
| title_fullStr | Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis |
| title_full_unstemmed | Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis |
| title_short | Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis |
| title_sort | intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries an updated systematic review and meta analysis |
| topic | analgesia intrathecal magnesium sulphate meta-analysis motor block pain sensory block spinal anaesthesia surgery |
| url | https://journals.lww.com/10.4103/ija.ija_862_24 |
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