Cargando…

Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial

BACKGROUND: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO(4)) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. AIMS: The aim of this study was to evaluate the effect of MgSO(4...

Descripción completa

Detalles Bibliográficos
Autores principales: Kaur, Shubhdeep, Dhawan, Jonny, Gupta, Ruchi, Chawla, Sunil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428122/
https://www.ncbi.nlm.nih.gov/pubmed/32843808
http://dx.doi.org/10.4103/aer.AER_96_19
_version_ 1783571012600725504
author Kaur, Shubhdeep
Dhawan, Jonny
Gupta, Ruchi
Chawla, Sunil
author_facet Kaur, Shubhdeep
Dhawan, Jonny
Gupta, Ruchi
Chawla, Sunil
author_sort Kaur, Shubhdeep
collection PubMed
description BACKGROUND: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO(4)) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. AIMS: The aim of this study was to evaluate the effect of MgSO(4) and ketamine on the duration of analgesia in brachial block. SETTINGS AND DESIGN: This was a prospective, randomized, controlled double-blind study. MATERIALS AND METHODS: One hundred and five adult patients were randomly divided into three groups: Group I = 27 mL of 0.5% ropivacaine; Group II = 27 mL of 0.5% ropivacaine + 250 mg MgSO(4); and Group II = 27 mL of 0.5% ropivacaine + 2 mg.kg(−1) ketamine. Normal saline was added to make a total volume of 30 mL. The onset and duration of the sensorimotor blockade, quality and duration of postoperative analgesia, and adverse effects were assessed. STATISTICAL ANALYSIS: Statistical analysis was performed using SPSS, version 17.0 software (SPSS, Inc., Chicago, IL, USA). Chi-square test was used for nonparametric and ANOVA for parametric data. Post hoc Student's paired t-test was applied wherever indicated. The results were expressed as mean and standard deviation or numbers (%). P < 0.05 was considered as statistically significant. RESULTS: The duration of analgesia was significantly longer in Group II (8.78 ± 0.97 h) compared to Group I (6.76 ± 0.92 h; P < 0.001) and Group III (7.1 ± 0.89 h; P < 0.001). Intervention groups had lower postoperative visual analog scores at 8, 12, and 24 h compared to the control group. Sedation, nystagmus, and hallucinations were observed in Group III. CONCLUSION: The addition of MgSO(4) to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia. MgSO(4) improves the quality of postoperative analgesia with lesser incidence of side effects when compared to ketamine.
format Online
Article
Text
id pubmed-7428122
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-74281222020-08-24 Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial Kaur, Shubhdeep Dhawan, Jonny Gupta, Ruchi Chawla, Sunil Anesth Essays Res Original Article BACKGROUND: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO(4)) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. AIMS: The aim of this study was to evaluate the effect of MgSO(4) and ketamine on the duration of analgesia in brachial block. SETTINGS AND DESIGN: This was a prospective, randomized, controlled double-blind study. MATERIALS AND METHODS: One hundred and five adult patients were randomly divided into three groups: Group I = 27 mL of 0.5% ropivacaine; Group II = 27 mL of 0.5% ropivacaine + 250 mg MgSO(4); and Group II = 27 mL of 0.5% ropivacaine + 2 mg.kg(−1) ketamine. Normal saline was added to make a total volume of 30 mL. The onset and duration of the sensorimotor blockade, quality and duration of postoperative analgesia, and adverse effects were assessed. STATISTICAL ANALYSIS: Statistical analysis was performed using SPSS, version 17.0 software (SPSS, Inc., Chicago, IL, USA). Chi-square test was used for nonparametric and ANOVA for parametric data. Post hoc Student's paired t-test was applied wherever indicated. The results were expressed as mean and standard deviation or numbers (%). P < 0.05 was considered as statistically significant. RESULTS: The duration of analgesia was significantly longer in Group II (8.78 ± 0.97 h) compared to Group I (6.76 ± 0.92 h; P < 0.001) and Group III (7.1 ± 0.89 h; P < 0.001). Intervention groups had lower postoperative visual analog scores at 8, 12, and 24 h compared to the control group. Sedation, nystagmus, and hallucinations were observed in Group III. CONCLUSION: The addition of MgSO(4) to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia. MgSO(4) improves the quality of postoperative analgesia with lesser incidence of side effects when compared to ketamine. Wolters Kluwer - Medknow 2020 2019-08-01 /pmc/articles/PMC7428122/ /pubmed/32843808 http://dx.doi.org/10.4103/aer.AER_96_19 Text en Copyright: © 2019 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kaur, Shubhdeep
Dhawan, Jonny
Gupta, Ruchi
Chawla, Sunil
Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title_full Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title_fullStr Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title_full_unstemmed Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title_short Comparison of Magnesium Sulfate and Ketamine with Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial
title_sort comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428122/
https://www.ncbi.nlm.nih.gov/pubmed/32843808
http://dx.doi.org/10.4103/aer.AER_96_19
work_keys_str_mv AT kaurshubhdeep comparisonofmagnesiumsulfateandketaminewithropivacaineinsupraclavicularbrachialplexusblockarandomizedcontrolledtrial
AT dhawanjonny comparisonofmagnesiumsulfateandketaminewithropivacaineinsupraclavicularbrachialplexusblockarandomizedcontrolledtrial
AT guptaruchi comparisonofmagnesiumsulfateandketaminewithropivacaineinsupraclavicularbrachialplexusblockarandomizedcontrolledtrial
AT chawlasunil comparisonofmagnesiumsulfateandketaminewithropivacaineinsupraclavicularbrachialplexusblockarandomizedcontrolledtrial