Document Detail

The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study.
MedLine Citation:
PMID:  20833531     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Combined spinal-epidural anaesthesia is commonly used for elective caesarean section. Intrathecal injection produces rapid onset with minimal doses of local anaesthetic and epidural administration can be used to prolong the block. Our study examined the effects of adding magnesium sulphate to epidural bupivacaine and fentanyl in patients undergoing elective caesarean section using combined spinal-epidural anaesthesia.
METHODS: Women ASA physical status I or II at term were recruited. All received 2 mL intrathecal 0.5% hyperbaric bupivacaine, 10 mL epidural 0.25% plain bupivacaine with fentanyl 100 μg, and were randomly allocated to receive either 10 mL of epidural 0.9% sodium chloride or 10 mL epidural 5% magnesium sulphate. The quality of surgical anaesthesia, incidence of hypotension, Apgar scores, intraoperative pain assessment, onset of postoperative pain, sedation scores and side effects were recorded in the postoperative period.
RESULTS: Ninety women were recruited. There was no difference in the time taken for the block to reach T4 sensory level, time to reach the highest level of sensory block, time interval between first neuraxial injection and onset of surgery between the groups. Women who received magnesium had greater motor block and muscle relaxation (P<0.05). Apgar scores were 7 or more in almost all neonates in both groups. There was no significant difference in the incidence of hypotension, nausea and vomiting and duration of motor blockade between the groups. Women who received magnesium showed less shivering and later onset of post operative pain (P<0.05).
CONCLUSION: The addition of magnesium to epidural bupivacaine and fentanyl in women undergoing elective caesarean section with combined spinal-epidural anaesthesia improved intraoperative conditions and the quality of postoperative analgesia.
A A Yousef; Y M Amr
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-09-15
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  19     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2011-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  401-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt.
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MeSH Terms
Adjuvants, Anesthesia* / adverse effects
Anesthesia, Epidural* / adverse effects
Anesthesia, Obstetrical* / adverse effects
Anesthesia, Spinal* / adverse effects
Anesthetics, Local* / adverse effects
Apgar Score
Bupivacaine* / adverse effects
Cesarean Section*
Double-Blind Method
Fentanyl* / adverse effects
Hypotension / epidemiology
Infant, Newborn
Magnesium Sulfate* / adverse effects
Pain Measurement / drug effects
Pain, Postoperative / drug therapy
Postoperative Nausea and Vomiting / epidemiology
Prospective Studies
Reg. No./Substance:
0/Adjuvants, Anesthesia; 0/Anesthetics, Local; 2180-92-9/Bupivacaine; 437-38-7/Fentanyl; 7487-88-9/Magnesium Sulfate

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