بررسی اثر افزودن منیزیوم سولفات به بوپی واکائین و فنتانیل در بی حسی نخاعی در بیماران تحت اعمال جراحی ارتوپدی اندام تحتانی

Background and aim: In recent years spinal anesthesia using a local anesthetic incombination with an opioid has gained popularity for lower limb operations due to the highsuccess rate and patient satisfaction, and the decreased resource utilization compared withgeneral anesthesia. In experimental studies, intrathecal administration of magnesium sulphate(MgSO4) significantly potentiated antinociception during spinal anesthesia however availabledata are scarce. This study aimed at evaluating the effect of adding MgSO4 to bupivacaine andfentanyl for spinal anesthesia in lower limb orthopaedic surgeries.Methods & materials: In this double-blind randomized clinical trial, 100 candidates ofspinal anesthesia for lower limp orthopaedic surgeries (ASA class I-II) were recruited in HazratRasoul Akram Medical Complrx in a 10-month period. They randomized in two equal age- andsex-matched groups receiving 1.0 ml of preservative-free 0.9% sodium chloride (group S) or 50mg of MgSO4 5% (1.0 ml) (group M) following 12.5 mg of bupivacaine 0.5% plus 25 μg offentanyl intrathecally. Date were collected regarding the time to reach the highest level ofsensory blockade, time to L2 regression, times to reach the highest level of motor blockade andits full regression, time to consumption the first dose of postoperative analgesic andcomplications.Results: Median time to reach the highest level of sensory blockade was significantly higherin the S group (16 vs. 14.5 min p=0.02). Median time to L2 regression (243 vs. 207 minp<0.001), as well as the median time to consumption the first dose of postoperative analgesic(345 vs. 232 min p<0.001) were significantly higher in the M group. Median times to reach thehighest level of motor blockade and its full regression were comparable between the two groups.Hypotension and bradycardia were recorded in 20% and 10% of the patients in group M and 30%and 14% of patients n group S, respectively (p=0. 35).Conclusion: Intrathecal MgSO4 along with the spinal anesthesia with bupivacaine andfentanyl in lower limb orthopaedic surgeries hasten the sensory blockade and prolongs the periodof anesthesia without additional side effects or influence on the motor blockade.