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 |
| _version_ | 1819125268811350016 |
|---|---|
| author | Sandip RoyBasunia Anjan Das Tapobrata Mitra Nairita Mayur Hirak Biswas Anindya Mukherjee Chiranjib Bhattacharyya Subrata Mandal |
| author_facet | Sandip RoyBasunia Anjan Das Tapobrata Mitra Nairita Mayur Hirak Biswas Anindya Mukherjee Chiranjib Bhattacharyya Subrata Mandal |
| author_sort | Sandip RoyBasunia |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T07:37:27Z |
| format | Article |
| id | doaj.art-c0ab90c0e41144099bc171ab12843067 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-22T07:37:27Z |
| publishDate | 2018-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-c0ab90c0e41144099bc171ab128430672022-12-21T18:33:51ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-12-011212UC01UC0510.7860/JCDR/2018/38012.12348Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled StudySandip RoyBasunia0Anjan Das1Tapobrata Mitra2Nairita Mayur3Hirak Biswas4Anindya Mukherjee5Chiranjib Bhattacharyya6Subrata Mandal7Assistant Professor, Department of Anaesthesiology, Midnapore Medical College, Midnapore, West Bengal, India.Associate Professor, Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.Assistant Professor, Department of Anaesthesiology, Murshidabad Medical College, Berhampore, West Bengal, India.R.M.O cum Clinical Tutor, Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.Assistant Professor, Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.Assistant Professor, Department of Anaesthesiology, N.R.S Medical College, Kolkata, West Bengal, India.Associate Professor, Department of Anaesthesiology, I.P.G.M.E & R, Kolkata, West Bengal, India.Professor, Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.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.https://jcdr.net/articles/PDF/12348/38012_CE[Ra1]_F(SL)_PF1(AB_SL)_PN(SL).pdfamerican society of anaesthesiologistsgeneral anaesthesiamagnesiumpost anaesthesia care unitthoracic paravertebral block |
| spellingShingle | Sandip RoyBasunia Anjan Das Tapobrata Mitra Nairita Mayur Hirak Biswas Anindya Mukherjee Chiranjib Bhattacharyya Subrata Mandal Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study Journal of Clinical and Diagnostic Research american society of anaesthesiologists general anaesthesia magnesium post anaesthesia care unit thoracic paravertebral block |
| title | Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study |
| title_full | Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study |
| title_fullStr | Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study |
| title_full_unstemmed | Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study |
| title_short | Role of Magnesium as Analgesic Sparing Adjuvant to Ropivacaine in Thoracic Paravertebral Block for Breast Cancer Surgery: A Prospective, Double-Blinded Randomised Controlled Study |
| title_sort | role of magnesium as analgesic sparing adjuvant to ropivacaine in thoracic paravertebral block for breast cancer surgery a prospective double blinded randomised controlled study |
| topic | american society of anaesthesiologists general anaesthesia magnesium post anaesthesia care unit thoracic paravertebral block |
| url | https://jcdr.net/articles/PDF/12348/38012_CE[Ra1]_F(SL)_PF1(AB_SL)_PN(SL).pdf |
| work_keys_str_mv | AT sandiproybasunia roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT anjandas roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT tapobratamitra roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT nairitamayur roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT hirakbiswas roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT anindyamukherjee roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT chiranjibbhattacharyya roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy AT subratamandal roleofmagnesiumasanalgesicsparingadjuvanttoropivacaineinthoracicparavertebralblockforbreastcancersurgeryaprospectivedoubleblindedrandomisedcontrolledstudy |