JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

[Does combination of intrathecal magnesium sulfate and morphine improve postcaesarean section analgesia?]

B E Ghrab, M Maatoug, N Kallel, K Khemakhem, M Chaari, K Kolsi, A Karoui
Annales Françaises D'anesthèsie et de Rèanimation 2009, 28 (5): 454-9
19427159

BACKGROUND: Intrathecal morphine (IT) is commonly used for postoperative analgesia after caesarean section. The addition of intrathecal (IT) magnesium to spinal bupivacaine-fentanyl anaesthesia increases the duration of spinal analgesia for labour without additional side effects. In this prospective, randomized, double blind, controlled study, we evaluated whether adding intrathecal magnesium could prolong spinal morphine analgesia after caesarean section. PARTURIENT AND METHODS: After ethics committee approval and obtaining written consent, one hundred and five (ASA I or II) adult patients undergoing caesarean section were recruited. They were randomly allocated to one of three groups: (1) group Morphine (M): 10 mg of isobaric bupivacaine 0.5% (2 ml)+100 microg morphine (1 ml)+10 microg fentanyl (0.1 ml)+1 ml of isotonic saline solution, (2) group Magnesium (Mg): 10mg of isobaric bupivacaine 0.5% (2 ml)+100mg of magnesium sulphate 10% (1 ml)+10 microg fentanyl (0.1 ml)+1 ml of isotonic saline solution, (3) group Morphine+Magnesium (MMg): 10mg of isobaric bupivacaine 0.5% (2 ml)+100mg of magnesium sulphate 10% (1 ml)+100 microg morphine (1 ml)+10 microg fentanyl (0.1 ml). We recorded the following: time to the first analgesic request, pain scores with the visual analogic scale at rest and in movement at h0, h1, h2, h4 and then every 4h for the first 36 postoperative hours, the occurrence of adverse events and patients' satisfaction.

RESULTS: Time of the first analgesic request was 28+/-8h in group MMg versus 19+/-6h in group M and 7+/-6h in group Mg (p<0.01). Pain scores were statistically lower in group MMg (9+/-7 and 17+/-9 mm respectively) compared to group M (16+/-9 and 28+/-11 mm respectively) and Mg (21+/-9 and 37+/-13 mm respectively) (p<0.01). There was no difference in adverse events among the three groups. Patients satisfaction was better in group MMg (p<0.01).

CONCLUSION: In patients undergoing caesarean section under spinal anaesthesia, the addition of IT magnesium sulphate (100mg) to morphine 100 microg improved the quality and the duration of postoperative analgesia without increasing the incidence of adverse effects.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
19427159
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"