Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study

Background: Intravenous regional anesthesia [IVRA] is a simple and effective anesthetic method for providing regional anesthesia of the upper limbs during carpal tunnel release surgery [CTRS]. However, the procedure is associated with significant postoperative pain and adjuvant analgesic agents are...

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Autores principales: Khaled Elsheshtawy, Ahmed Elsawy, Ahmed Abouelnasr Khalifa
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Publicado: Al-Azhar University, Faculty of Medicine (Damietta) 2021
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spelling oai:doaj.org-article:820a19f9803448658917759c606cb21c2021-12-02T17:05:59ZMagnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study2636-41742682-378010.21608/ijma.2021.72475.1299https://doaj.org/article/820a19f9803448658917759c606cb21c2021-07-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_186028_204d6850b72596b96c0548d022466b56.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Intravenous regional anesthesia [IVRA] is a simple and effective anesthetic method for providing regional anesthesia of the upper limbs during carpal tunnel release surgery [CTRS]. However, the procedure is associated with significant postoperative pain and adjuvant analgesic agents are recommended. The Aim of The Work: This study aimed to compare the analgesic effects of magnesium sulfate and tramadol when added to lidocaine for IVRA during CTRS. Methods: In this double-blinded, randomized clinical trial, 60 ASA I-II patients eligible for elective CTRS with IVRA were randomly allocated into one of 3 groups. The first group [lidocaine group] received IVRA with 40 ml lidocaine 0.5%. The second group [lidocaine + tramadol group] received IVRA with40 ml 0.5% lidocaine and tramadol 1mg/kg. The third group [lidocaine + magnesium sulphate group] received IVRA with 40 ml 0.5% lidocaine and magnesium sulfate 10 mg/kg and normal saline. Outcome parameters included time to onset of sensory and motor block, time to onset of tourniquet pain, need of intra-operative analgesia, intraoperative consumption of fentanyl, duration of postoperative analgesia and pain intensity were noted in each patient. Results: Comparison between the studied groups regarding the outcome parameters. The Lidocaine + Tramadol and the Lidocaine + Magnesium groups achieved better performance in all the studied parameters in comparison to the Lidocaine group. In addition, Lidocaine + Tramadol groups had significantly better performance in comparison to the Lidocaine + Magnesium group. No significant differences were reported between the studied groups regarding post-operative complications Conclusions: Use of tramadol and magnesium sulphate as adjuvants to lidocaine achieved better performance in all the studied parameters in comparison to the lidocaine only. In addition, tramadol had significantly better performance in comparison to magnesium sulphate without significant side effects.Khaled ElsheshtawyAhmed ElsawyAhmed Abouelnasr KhalifaAl-Azhar University, Faculty of Medicine (Damietta)articlemagnesium sulfatetramadolintravenous regional anesthesiacarpal tunnel release surgeryMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 3, Pp 1708-1713 (2021)
institution DOAJ
collection DOAJ
language EN
topic magnesium sulfate
tramadol
intravenous regional anesthesia
carpal tunnel release surgery
Medicine (General)
R5-920
spellingShingle magnesium sulfate
tramadol
intravenous regional anesthesia
carpal tunnel release surgery
Medicine (General)
R5-920
Khaled Elsheshtawy
Ahmed Elsawy
Ahmed Abouelnasr Khalifa
Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
description Background: Intravenous regional anesthesia [IVRA] is a simple and effective anesthetic method for providing regional anesthesia of the upper limbs during carpal tunnel release surgery [CTRS]. However, the procedure is associated with significant postoperative pain and adjuvant analgesic agents are recommended. The Aim of The Work: This study aimed to compare the analgesic effects of magnesium sulfate and tramadol when added to lidocaine for IVRA during CTRS. Methods: In this double-blinded, randomized clinical trial, 60 ASA I-II patients eligible for elective CTRS with IVRA were randomly allocated into one of 3 groups. The first group [lidocaine group] received IVRA with 40 ml lidocaine 0.5%. The second group [lidocaine + tramadol group] received IVRA with40 ml 0.5% lidocaine and tramadol 1mg/kg. The third group [lidocaine + magnesium sulphate group] received IVRA with 40 ml 0.5% lidocaine and magnesium sulfate 10 mg/kg and normal saline. Outcome parameters included time to onset of sensory and motor block, time to onset of tourniquet pain, need of intra-operative analgesia, intraoperative consumption of fentanyl, duration of postoperative analgesia and pain intensity were noted in each patient. Results: Comparison between the studied groups regarding the outcome parameters. The Lidocaine + Tramadol and the Lidocaine + Magnesium groups achieved better performance in all the studied parameters in comparison to the Lidocaine group. In addition, Lidocaine + Tramadol groups had significantly better performance in comparison to the Lidocaine + Magnesium group. No significant differences were reported between the studied groups regarding post-operative complications Conclusions: Use of tramadol and magnesium sulphate as adjuvants to lidocaine achieved better performance in all the studied parameters in comparison to the lidocaine only. In addition, tramadol had significantly better performance in comparison to magnesium sulphate without significant side effects.
format article
author Khaled Elsheshtawy
Ahmed Elsawy
Ahmed Abouelnasr Khalifa
author_facet Khaled Elsheshtawy
Ahmed Elsawy
Ahmed Abouelnasr Khalifa
author_sort Khaled Elsheshtawy
title Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
title_short Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
title_full Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
title_fullStr Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
title_full_unstemmed Magnesium Sulfate versus Tramadol as Adjuvants to Lidocaine in Intravenous Regional Anesthesia for Carpal Tunnel Release Surgery: A Randomized Clinical Study
title_sort magnesium sulfate versus tramadol as adjuvants to lidocaine in intravenous regional anesthesia for carpal tunnel release surgery: a randomized clinical study
publisher Al-Azhar University, Faculty of Medicine (Damietta)
publishDate 2021
url https://doaj.org/article/820a19f9803448658917759c606cb21c
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AT ahmedelsawy magnesiumsulfateversustramadolasadjuvantstolidocaineinintravenousregionalanesthesiaforcarpaltunnelreleasesurgeryarandomizedclinicalstudy
AT ahmedabouelnasrkhalifa magnesiumsulfateversustramadolasadjuvantstolidocaineinintravenousregionalanesthesiaforcarpaltunnelreleasesurgeryarandomizedclinicalstudy
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