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Evaluation of analgesia using magnesium sulphate by different routes in knee arthroscopy

Magnesium Sulphate in Arthroscopy Magnesium Sulphate in Arthroscopy
Magnesium Sulphate in Arthroscopy Magnesium Sulphate in Arthroscopy

A randomized controlled trial aimed to compare the analgesic effect and probable adverse effects of distinct routes of administration of magnesium sulphate (MgSO4) in patients undergoing knee arthroscopy under spinal anesthesia.

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Key take away

During knee arthroscopy under spinal anesthesia, administration of magnesium sulphate intra-articularly showed superiority over other administration routes or not using at all.

Background

A randomized controlled trial aimed to compare the analgesic effect and probable adverse effects of distinct routes of administration of magnesium sulphate (MgSO4) in patients undergoing knee arthroscopy under spinal anesthesia.

Method

A total of 196 participants undergoing knee surgery were segregated into four groups with 49 participants in each group. During spinal anesthesia, patients in group A were given bupivacaine intrathecally and patients in group B received 50 mg magnesium sulphate + bupivacaine intrathecally. Group C patients were intravenously administered magnesium sulphate 10 minutes following intrathecal injection (30 mg/kg MgSO4).

Participants in group D were administered magnesium sulphate intra-articularly, 10 min prior to the end of surgery (800 MgSO4 diluted in 12 ml normal saline (0.9 % NaCl). Analysis of side effects, mean arterial pressure, pulse rate, total dose of rescue analgesics used, time-lapse before first analgesic dose after surgery, visual analog scale (VAS) at rest and after the procedure, and operative time in minutes were done.

Result

In patients receiving intra-articular magnesium sulphate, the total tramadol doses utilized during 24 hrs following the procedure were remarkably better compared to other groups with respect to the time lapse between the first rescue analgesic given and the end of surgery.

Contrasted to the patients who were given intrathecal magnesium sulphate, the Group C patients who received intravenous administration of magnesium sulphate were substantially better concerning the time taken from the end of surgery until the first analgesic dose. In patients who were administered magnesium sulphate intraarticularly, VAS at rest and during the period of the first 24 hours followed by surgery was statistically significant.

Conclusion

In knee arthroscopy patients, the use of intra-articular route of magnesium sulphate was associated with better pain reduction than other administration routes or not utilizing at all. Furthermore, intravenous magnesium sulphate showed superiority over intrathecal route in offering postoperative analgesia.

Source:

Journal of Evolution of Medical and Dental Sciences

Article:

A Randomized Controlled Trial on Assessment of Analgesia on Using Magnesium Sulphate by Different Routes in Patients Undergoing Arthroscopy of Knee under Spinal Anaesthesia

Authors:

Ch Anil Kumar et al.

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