Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study
Introduction: Thoracic surgeries are often associated with intractable pain leading to postoperative pulmonary complications. To alleviate this pain in intraoperative and postoperative period, Thoracic Paravertebral Block (TPVB) has been proven as an effective mean. Various adjuvants and their...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2018-12-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/12348/38012_CE[Ra1]_F(SL)_PF1(AB_SL)_PN(SL).pdf |
| Summary: | Introduction: Thoracic surgeries are often associated
with intractable pain leading to postoperative pulmonary
complications. To alleviate this pain in intraoperative and
postoperative period, Thoracic Paravertebral Block (TPVB) has
been proven as an effective mean. Various adjuvants and their
mixtures have been tried to prolong the duration of TPVB.
Aim: In this randomised controlled study, we have evaluated
the analgesic sparing efficacy of magnesium sulfate; a NMDA
receptor antagonist, administered along with ropivacaine for
TPVB for breast cancer surgery patients.
Materials and Methods: Eighty breast cancer surgery patients,
undergoing General Anaesthesia (GA), were randomly divided
into group RP and group RM (n=40 each) receiving preoperative
TPVB at T3-5 level with 0.5% ropivacaine solution admixture
with normal saline and magnesium sulphate, respectively.
Intraoperative fentanyl and propofol requirement was compared.
Visual Analogue Scale (VAS) was used for postoperative pain
assessment. Total dose and mean time to administration of
first rescue analgesic paracetamol was noted. Side effects and
haemodynamic parameters were also noted.
Results: Intraoperative fentanyl (153.86 vs. 138.49 µg), propofol
requirement (150.34 vs. 134.23 mg) was significantly less in test
(magnesium) group. The requirement of paracetamol was also
significantly less (1592.09 vs. 1149.23 mg) and later (8.44 vs.
13.34 hour) in group RM than group RP. Haemodynamics and
side effects were comparable among two groups.
Conclusion: Magnesium provided better intraoperative as well
as postoperative analgesia than placebo when administered
with ropivacaine in TPVB prior to breast cancer surgery patients.
It also renders a lesser analgesic requirement without major
haemodynamic alteration and side effects. |
|---|---|
| ISSN: | 2249-782X 0973-709X |