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MAGNESIUM SULPHATE AS AN ADJUVANT TO UPPER LIMB REGIONAL ANAESTHESIA AND ITS EFFECT ON DURATION OF ANALGESIA, MOTOR AND SENSORY BLOCK: A META-ANALYSIS
ESRA Academy. sharma n. Sep 8, 2016; 138541
Topic: Adjuvant Drugs
namita sharma
namita sharma

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Abstract
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Background and Aims:

Shoulder arthroscopy is performed, not only as a diagnostic tool but also therapeutically, most suitably under an interscalene block [Anesth Analg 1999; 89:1 21 6–1220.]. Prolonged duration of local anaesthetics is desirable as patients develop severe pain on the first postoperative day after the effect of the local anaesthetic (LA) has worn off. A number of  LA adjuvants including magnesium sulphate [Ain-Shams Journal of Anesthesiology 2015, 08:402–406], have been evaluated for their ability to prolong the duration of LA block with varied results. We performed a meta-analysis to find out if addition of magnesium sulphate prolongs the duration of motor block.

Methods:

Pubmed, EMBASE, national, international conferences and google scholar search using words magnesium sulphate, magnesium sulfate, brachial plexus block, interscalene, axillary, supraclavicular retrieved RCT’s comparing LA versus LA + magnesium for upper limb surgery. The data were analysed using RevMan software. The primary outcome was the duration of motor block. Secondary outcomes included duration of sensory block and duration of analgesia.

Results:

10 Trials (618 patients) were included in the meta-analysis. Addition of magnesium sulphate prolonged duration of motor block SMD (95% CI) -1.54[-2.55, -0.54], P = 0.003. Secondary outcomes as in Table 1.

Table 1.


Conclusions:

Addition of magnesium sulphate to LA prolongs the duration of motor block, sensory block and duration of analgesia. Magnesium sulphate has antinociceptive effects by blocking the N-methyl-D-aspartate receptor and associated calcium channels, thus preventing the central sensitization that is caused by peripheral nociceptive stimulation [Curr Drug Targets 2009; 10:734–743].

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