Addition Of Magnesium Sulfate Research Articles

Evalution of the Effect of Addition of Magnesium Sulfate to Local Anesthetics for Peribulbar Block: a Meta-Analysis for Randomized Trials

Evalution of the Effect of Addition of Magnesium Sulfate to Local Anesthetics for Peribulbar Block: a Meta-Analysis for Randomized Trials

The Effects of Magnesium Sulfate with Lidocaine for Infraclavicular Brachial Plexus Block for Upper Extremity Surgeries.

Background An addition of analgesic to anesthetic agents is likely to increase the effects of anesthesia and reduce associated adverse outcomes. Several adjuvants are studied in this regard. The aim of this study is to investigate the effects of adding a magnesium adjunct to lidocaine for the induction of infraclavicular block. Methods Patients referred to Shohada Ashayer Hospital, Khorramabad, for wrist and hand surgery were enrolled in this study. The intervention/case group included patients who received 18 mL lidocaine (2%) + 2 mL magnesium sulfate (50%), 10 mL normal saline; control group: 18 mL lidocaine (2%) + 12 mL of normal saline. After the induction of ultrasound-guided infraclavicular block, parameters such as duration of reach with respect to complete sensory and motor block, hemodynamic parameters (hypotension and bradycardia), and postoperative pain, using visual analogue scale criteria, were measured. The obtained data were analyzed using a Bayesian path analysis model. Results A total of 30 patients were included in each group. In the case group, sensory and motor block was achieved for 12.136 ± 4.96 and 13 ± 3.589 minutes more than those in the control group. The duration of sedation and immobilization was 2.57 ± 0.764 minute and 4.66 ± 0.909 minutes lengthier in the case group. Regarding the hemodynamic parameters, blood pressure was 0.217 ± 5.031 and 1.59 ± 5.14 units lower in the case group, immediately following the block and the surgery. Similarly, heart rate was 0.776 ± 4.548 and 0.39 ± 3.987 units higher in the case group, after 30 minutes and 2 hours of the procedure. A decrease in the pain was seen at 8, 10, and 12 hours after the surgery, as compared with the control group. An addition of magnesium to lidocaine for infraclavicular block resulted in a significantly longer sedation and immobilization period and decreased postoperative pain at 12 hours. Conclusion Heart rate and blood pressure did not decrease significantly in the case group. It can be concluded that addition of magnesium sulfate to lidocaine can produce better anesthetic and analgesic outcomes with low-to-no adverse effects.

Pain control for laparoscopic hysterectomy with magnesium versus nalbuphine added to intraperitoneal bupivacaine: a randomized double-blinded study

Background Pain control for laparoscopic hysterectomy carries some concerns. Intraperitoneal bupivacaine either alone or with additives has been studied with favorable results. However, adding nalbuphine has not been sufficiently examined. This study aimed to compare between the addition of magnesium sulfate (MgSO4) or nalbuphine to bupivacaine regarding efficacy and drawbacks. Patients and methods A total of 80 female patients of American Society of Anesthesiologists I–II scheduled for laparoscopic hysterectomy in Ain Shams University hospitals were randomly distributed into two groups: group bupivacaine magnesium (BM) (n=40), in which patients received 30 ml of intraperitoneal bupivacaine 0.25% plus 30 mg/kg MgSO4, and group bupivacaine nalbuphine (BN) (n=40), in which patients received 30 ml of intraperitoneal bupivacaine 0.25% plus 5-mg nalbuphine at the end of operation. A standard general anesthesia technique was used in all patients. Visual analog scale, total intravenous diclofenac consumption, the time for first analgesia requirement, incidence of adverse effects, and patient satisfaction in the first 24 h postoperatively were recorded in both groups. Results BN group experienced prolonged postoperative pain-free period. Total diclofenac consumption and pain scores were significantly less in BN group as compared with BM group. Regarding the adverse effects, there was insignificant difference between both groups for incidence of shoulder pain; however, BN group experienced more postoperative nausea and vomiting. Other adverse events were not reported. Patient satisfaction was significantly higher in BN group when compared with BM group. Conclusion This study showed that addition of nalbuphine to bupivacaine for intraperitoneal instillation gave better postoperative pain control when compared with adding MgSO4 to bupivacaine.

Efficacy and Safety of Magnesium versus Dexmedetomidine as Additives to Local Anesthetic Mixture Using Single Injection Percutaneous Peribulbar Anesthesia in Vitreoretinal Surgeries

Background: Peribulbar block for vitreoretinal surgery is rather associated with delayed onset of globe anesthesia, akinesia and short duration of analgesia. Objective: To compare the effect of addition of Magnesium sulphate vs dexmedetomidine to standard local anesthetics mixtures on the time of onset of Globe Anesthesia, Akinesia & analgesia duration. Patients and Methods: Ninety patients of both sexes, aged 25- 75 years, ASA I-III scheduled for vitreoretinal surgery. They were randomly allocated into 3 equal groups each received peribulbar block a mixture of Levo- bupivacaine 0.5% (3 ml) + lidocaine 2% (3 ml) +120 IU hyaluronidase + Control group (C): 0.5 ml of Normal saline. Group (M): 50 mg of Magnesium sulphate in 0.5 ml normal saline. Group (D): 50 μic of dexmedetomidine in 0.5 ml normal saline. The duration of sensory, motor block, Sedation level, Intra-ocular Pressure (IOP) and surgeon satisfaction were assessed. Results: The onset of globe anesthesia and akinesia was significantly shorter in M group in comparison with D and C Groups, with a significant increase in the duration of globe analgesia and akinesia in the D Group when compared to both M & C groups. Groups D and M showed a statistically significant decrease in the IOP at 5 min and 10 min when compared to the baseline measurement of the same groups & to C Group, no complications or adverse effects related to the drug or technique were recorded. Conclusion: Magnesium sulphate as a local anesthetic adjuvant in peribulbar block is safe and comparable to dexmedetomidine regarding the sensory and motor block duration with better cost-effectiveness and availability.

Comparison between 3 Different Doses of Magnesium Sulphate as A Spinal Adjuvant to Bupivacaine and Fentanyl Combination in Lower Limb Orthopedic Surgery

AbstractBackground: Spinal anesthesia is a simple technique that provides a fast surgical block. It has certain limitations such as limited duration of the blockade and post-operative anal-gesia. Adjuncts to the Local Anaesthetics (LA) used in spinal anaesthesia can exhibit undesirable side-effects like respiratory depression, urinary retention, pruritis, haemodynamic insta-bility and nausea and vomiting, limiting their use. Magnesium when used in therapeutic doses avoids all of these side-effects.Objective: Comparing 3 different doses of Magnesium Sulfate as a spinal adjuvant to Bupivacaine-Fentanyl combi-nation in spinal anesthesia on the spread, duration, regression of spinal block, and postoperative analgesia in patients under-going lower limb orthopedic surgeries.Patients and Methods: This study was conducted in Assuit University Hospital in period from 1/8/2016 to 31/7/2017. 120 patients aged between 18-60 years, 30 in each group (ASA I or II) scheduled for lower limb orthopedic surgeries were included in our study. The patients were randomly divided into four equal groups of 30 each: Group I (control group) patients received intrathecal injection hyperbaric bupivacaine (0.5%) 2.5ml with fentanyl (25μg) 0.5ml and normal saline 1ml. Group II patients received intrathecal injection hyperbaric bupivacaine (0.5%) 2.5ml with fentanyl (25μg) 0.5ml, MgSO4 (50mg) 0.5ml and normal saline 0.5ml. Group III patients received intrathecal injection hyperbaric bupivacaine (0.5%) 2.5ml with fentanyl (25μg) 0.5ml, MgSO4 (75mg) 0.75ml and normal saline 0.25ml. Group IV patients received intrathecal injection hyperbaric bupivacaine (0.5%) 2.5ml with fentanyl (25μg) 0.5ml and MgSO4 (100mg) 1ml. Onset and duration of sensory & motor block, time to reach the maximum height of the sensory block and incidence of side effects were recorded. Numerical Rating Scale (NRS) was recorded every 6 hours for the next 24 hours.Results: As regards onset of motor & sensory block, it was delayed in all groups than in control group. As regards duration of motor & sensory block, it was prolonged in all groups than in control group I. The results of our study showed that addition of Magnesium Sulphate to IT Bupivacaine-Fentanyl provides longer duration of analgesia than Bupi-vacaine-Fentanyl alone. Also total analgesic requirements were more in control group than other groups specially group IV which had the least analgesic requirements. As regards side effects our study showed that there were higher incidence of hypotension, nausea & vomiting in group IV when compared with groups II and III.Conclusion: Our study shows that the addition of magne-sium sulfate to intrathecally bupivacaine-fentanyl in patients undergoing lower limb orthopedic surgery receiving spinal anesthesia prolongs the duration and quality of analgesia better than bupivacaine-fentanyl only but 75mg of this drug was enough to lead a significant delay in the onset of both sensory and motor blockade, and prolonged the duration of sensory and motor blockade, without increasing side effects like hypotension, nasuea & vomiting.

An Evaluation of the Adding Magnesium Sulfate to Ropivacaine on Ultrasound-Guided Transverse Abdominis Plane Block After Abdominal Hysterectomy.

BackgroundPost-hysterectomy pain is extremely annoying and using transverse abdominis plane (TAP) block can be a useful method to manage postoperative pain, but its duration of effect is challenging. Magnesium sulfate increases, in some cases, the effects of local anesthetics on the peripheral nerve blocks.ObjectivesThe current study aimed at investigating the effects of adding magnesium sulfate to ropivacaine in the transverse abdominis plane block after hysterectomy.MethodsThe current randomized, double blind, clinical trial, to manage postoperative pain, was conducted on a total of 60 patients, 30 - 60 years old, ASA (American Society of Anesthesiologists) class I-II undergone elective abdominal hysterectomy candidates to receive ultrasound-guided bilateral transverse abdominis abdominis plane (TAP) blocks. Patients with coagulation disorders, infection, history of any addiction, sensitivity to the local anesthetics and magnesium sulfate were excluded. The subjects were equally allocated into two groups, the control group, ropivacaine plus normal saline (R), and the study group, ropivacaine plus magnesium sulfate (RM). The injection contained 19 mL ropivacaine 0.2% plus 1 mL normal saline in the group R, and 19 mL ropivacaine 0.2% plus 1 mL magnesium sulfate 50% in the RM group on each side. As well as the patients’ characteristics, the level of pain score (visual analogue scale = VAS), rescue analgesic demand (diclofenac suppository), and possible adverse effects were evaluated at 1, 2, 6, 12, and 24 hours after the operation in the two groups.ResultsThe mean pain scores of the patients at the first hour after surgery were 5.7 ± 0.9 and 5.9 ± 1.1 in R and RM groups, respectively. The scores reached 2.9 ± 0.5 and 2.7 ± 0.4 at the second hour after surgery (the first post-block measurement) and 3.1 ± 0.7 and 2.8 ± 0.7 within the next 24 hours, respectively. Although the pain scores were generally lower at all hours in the RM group, none was statistically significant. The rescue analgesic consumption gradually increased in the two groups, and it was less in the study group than in the control group in the first hours after the block (second hour after surgery); however, it was not statistically significant. No adverse effects were observed in the two groups.ConclusionsResults of the current study suggested that the addition of magnesium sulfate to ropivacaine in TAP block does not affect the post-hysterectomy pain.

Cooperative Decomposition of Hydrogen Peroxide by Lignin-combined Transition Metals in Pulp Bleaching

The effects of lignin-combined manganese ion, iron ion, and lignin-combined iron and manganese on the decomposition of hydrogen peroxide were investigated. Elemental analysis and inductively coupled plasma-atomic emission spectrometry were used to analyze the chemical features of the lignin composites and the amount of metal ions present in the solution or adsorbed on lignin, respectively. The results showed that the main transition metal elements remaining in the precipitated lignin were Fe, Mn, and Cu. The hydrogen peroxide decomposition in the presence of lignin-combined transition metal was represented by pseudo-first-order kinetics, and the pseudo-first-order rate constant (kobs) of peroxide decomposition with lignin-combined iron was 0.0068 min-1, while it was 0.0063 min-1 in the presence of lignin-combined manganese. A synergistic effect of manganese and iron combined with lignin on peroxide decomposition was demonstrated, and a kobs value of 0.0053 min-1 was obtained. The mixed addition of magnesium sulfate (MgSO4), sodium silicate (Na2SiO3), and ethylene diamine tetraacetic acid disodium salt (Na2EDTA) resulted in an optimal reduction in peroxide decomposition when single lignin-combined metal ion existed. However, adding Na2EDTA alone had an optimal effect on the reduction of peroxide decomposition in the presence of lignin-combined iron and manganese, with a kobs value of 0.0004 min-1.

Comparison of 0.5% Ropivacaine with 0.5% Ropivacaine and Magnesium sulphate in supraclavicular brachial plexus block for forelimb and hand surgeries

Objectives: Supraclavicular Brachial Plexus is commonly used for forelimb and hand surgeries. A lot of research is going on to increase the duration of sensory and motor blockade by the addition of adjuvants with the local anesthetics. We evaluated the effect of adding magnesium sulphate to ropivacaine for supraclavicular brachial plexus blockade. Our primary parameters were the onset and duration of sensory and motor block and duration of analgesia. Methods: 60 patients posted for elective forearm and hand surgeries under supraclavicular brachial plexus block were divided into two equal groups (Group RM and RN) in a double blind fashion. In Group RM 30ml 0.5% ropivacaine plus 150 mg magnesium sulphate in (1 ml 0.9% saline) and in group RN 1ml of normal saline was added to ropivacaine. Results: Both the groups have similar demographic profile and time of onset of senory and motor block but the duration of senory and motor blockade and duration of analgesia were significantly longer in RM group than RN group. Intraoperative hemodynamics were compareable amoung two groups and no considerable side effects were noted in both the groups. Conclusion: It can be concluded from our study that by addition of magnesium sulphate to local anesthetics in supraclavicular brachial plexus block may increase the duration of senory and motor blockade and duration of analgesia with no appreciable side effects, however duration of onset of sensory and motor blockade was more in magnesium sulphate group.

A Comparative study on Adenosine and Magnesium Sulphate with Bupivacaine in Infraclavicular infusion for Postoperative Analgesia

Background: Brachial plexus piece has reformed the field of regional anaesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without significant difficulties. Aim: To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia. Materials & Methods: This Prospective study was done at the Department of Anaesthesiology, Govt. Medical College, Azamgarh. Around 24 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-12) and B (n-12) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B - magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. Results: Our Study revealed that Group A had a faster Onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. Conclusion: The addition of magnesium sulphate as an additive to bupivacaine in brachial plexus block may be a better choice when prolonged postoperative analgesia is required.

Adenosine and Magnesium Sulphate Vs Bupivacaine in Infraclavicular Infusion for Upper Limb Surgeries and Post-Operative Analgesia: A Prospective Study

Background: Brachial plexus piece has reformed the field of regional anesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without significant difficulties. Aim: To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia. Methods: This Prospective study was done at the Department of Anaesthesiology, Pacific Medical College and Hospital, Udaipur, Rajasthan. Around 30 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-15) and B (n-15) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B - magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. Results: Result s showed that Group A had a faster Onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. Though Group B had a higher incidence of sedation and vomiting than group A, it was not significant. Conclusions: The addition of magnesium sulphate as an additive to bupivacaine in brachial plexus block may be a better choice when prolonged postoperative analgesia is required.

The Effect of Magnesium Sulfate on Postoperative Pain in Upper Limb Surgeries by Supraclavicular Block Under Ultrasound Guidance.

BackgroundPrevious studies have been conducted to evaluate the effect of different adjuvants on brachial plexus block.ObjectivesThis study investigated the effect of adding magnesium sulfate to lidocaine on postoperative pain in upper limb surgeries by supraclavicular brachial plexus block under ultrasound guidance.MethodsThis study was carried out on patients who were candidate for upper limb surgeries. This was a controlled double-blind study conducted on a number of 52 patients aged 18 - 75 years with ASA class I or II. The first group (M) received lidocaine 1% (4 mg/kg) plus fentanyl 50 micg and magnesium sulfate 20% (5 mL) while the second group (N) received lidocaine 1% (4 mg/kg) plus fentanyl 50 micg and normal saline (5 mL) to supraclavicular brachial plexus block under ultrasound guidance. Postoperative pain was evaluated by visual analog scale (VAS) until 24 hours. Sensory and motor blocks onset and duration, rescue analgesics, hemodynamic variables, and side effects were recorded for all the patients.ResultsPostoperative VAS values at 24 hours were significantly lower in group M than group N (P < 0.0001). Sensory and Motor blocks onset and duration were statistically longer in group M than group N (P < 0.0001).ConclusionsThe addition of magnesium sulfate to lidocaine decreased the postoperative pain and increased the onset and duration of sensory and motor blocks in supraclavicular brachial plexus block under ultrasound guidance in upper limb surgeries.

Comparison of two different doses of magnesium sulphate for spinal anaesthesia: a prospective, randomized double-blind study

Background: The present study aim was designed to compare and evaluate the efficacy of adding two different doses of magnesium sulphate to 0.5% hyperbaric levobupivacaine for spinal anaesthesia in terms of block characteristics, haemodynamic and safety profile. Methods: Ninety American Society of Anaesthesiologist (ASA) grade I–II patients undergoing elective infra-umbilical surgeries under spinal anaesthesia were randomly allocated into three groups. Group C (n=30, control group) received 3 mL (15 mg) of 0.5% hyperbaric levobupivacaine; Group M50 (n=30): received 3 mL (15 mg) of 0.5% hyperbaric levobupivacaine + 50 mg of magnesium sulphate. Group M100 (n=30) received 3 mL (15 mg) of 0.5% hyperbaric levobupivacaine + 100 mg of magnesium sulphate. A standard protocol was followed after which a blinded observer assessed the sensory and motor blocks. The onset and duration of sensory (pin-prick) block, onset, intensity and duration of motor block were recorded. Results: All the subarachnoid blocks were adequate. The addition of magnesium sulphate to intrathecal levobupivacaine had not only increased the time to onset of sensory block (p=0.007) but also prolonged the duration of sensory (p<0.001) and motor block (p<0.001) to statistically significant level in a dose dependent manner. Conclusions: Addition of magnesium sulphate does not offer any further advantage in terms of haemodynamic stability. However, it certainly increases the duration of sensory block to a significant level.

Proteome Analysis Is a Valuable Tool to Monitor Antigen Expression during Upstream Processing of Whole-Cell Pertussis Vaccines.

Physicochemical and immunochemical assays were applied to substantiate the relation between upstream processing and the quality of whole-cell pertussis vaccines. Bordetella pertussis bacteria were cultured on a chemically defined medium using a continuous cultivation process in stirred tank reactors to obtain uniform protein expression. Continuous culture favors the consistent production of proteins known as virulence factors. Magnesium sulfate was added during the steady state of the culture in order to diminish the expression of virulence proteins. Changes in gene expression and antigen composition were measured by microarrays, mass spectrometry and ELISA. Transcriptome and proteome data revealed high similarity between the biological triplicates demonstrating consistent cultivation of B.pertussis. The addition of magnesium sulfate resulted in an instant downregulation of the virulence genes in B.pertussis, but a gradual decrease of virulence proteins. The quantity of virulence proteins concurred highly with the potency of the corresponding whole-cell pertussis vaccines, which were determined by the Kendrick test. In conclusion, proteome analysis provided detailed information on the composition and proportion of virulence proteins present in the whole-cell preparations of B.pertussis. Moreover, proteome analysis is a valuable method to monitor the production process of whole-cell biomass and predict the product quality of whole-cell pertussis vaccines.

Inhaled short-acting bronchodilators for managing emergency childhood asthma: an overview of reviews

International guidelines provide conflicting recommendations on how to use bronchodilators to manage childhood acute wheezing conditions in the emergency department (ED), and there is variation within and among countries in how these conditions are managed. This may be reflective of uncertainty about the evidence. This overview of systematic reviews (SRs) aimed to synthesize, appraise, and present all SR evidence on the efficacy and safety of inhaled short-acting bronchodilators to treat asthma and wheeze exacerbations in children 0-18years presenting to the ED. Searching, review selection, data extraction and analysis, and quality assessments were conducted using methods recommended by The Cochrane Collaboration. Thirteen SRs containing 56 relevant trials and 5526 patients were included. Results demonstrate the efficacy of short-acting beta-agonist (SABA) delivered by metered-dose inhaler as first-line therapy for younger and older children (hospital admission decreased by 44% in younger children, and ED length of stay decreased by 33min in older children). Short-acting anticholinergic (SAAC) should be added to SABA for older children in severe cases (hospital admission decreased by 27% and 74% when compared to SABA and SAAC alone, respectively). Continuous nebulization, addition of magnesium sulfate to SABA, and levosalbutamol compared to salbutamol cannot be recommended in routine practice.

Magnesium sulfate or diltiazem as adjuvants to total intravenous anesthesia to reduce blood loss in functional endoscopic sinus surgery

Study objectiveThis study was designed to know whether addition of magnesium sulfate (MgSO4) or diltiazem to total intravenous anesthesia (TIVA) (propofol) aided reduction in blood loss during functional endoscopic sinus surgery (FESS). The secondary outcomes measured were surgeon's assessment of the surgical field and hemodynamics. DesignRandomized, double-blinded, placebo-controlled trial. SettingOperating room. PatientsForty-five American Society of Anesthesiologists I and II adult patients (18-60years) undergoing FESS. InterventionsAll groups received propofol-fentanyl TIVA. Patients were randomly allocated to 1 of the 3 groups (MgSO4 group, n=15; diltiazem group, n=15; saline group, n=15). MeasurementsIntraoperative bleeding was quantified, and quality of surgical field was graded. Hemodynamic parameters were recorded. Main resultsAddition of both MgSO4 and diltiazem significantly reduced blood loss (240 and 350mL) in comparison to control group (415mL) (P=.003). The surgical field was significantly better in the MgSO4 group compared with the diltiazem (P=.028) and saline groups (P=.0001). ConclusionIt was concluded that the addition of both MgSO4 and diltiazem to TIVA propofol results in significant reduction in blood loss and significant improvement in the quality of surgical field during FESS without causing any adverse effects on the hemodynamics or on the recovery from anesthesia. The surgical field in the MgSO4 group was significantly better than that in the diltiazem group (P=.04).

Todetermine the effects of addition of magnesium sulphate to Bupivacaine-fentanyl spinal anaesthesia with respect to sensory and motor blockade

Background: One of the recent additions to the list of adjuvants that are used intrathecally, is Magnesium. It may improve the quality and duration of spinal anaesthesia. It acts by blocking the N-methyl-D-asparate (NMDA) channels in a voltage dependent way, reducing NMDA – induced currents. While the systemic use of Magnesium sulphate (MgSO4) reduces the postoperative opioid requirements, its intrathecal use is not evaluated extensively. Objectives: To determine the effect of addition of magnesium sulphate to Bupivacaine – fentanyl spinal anaesthesia with respect to onset of sensory and motor blockade, duration of analgesia and adverse effects if any. Methods: A prospective non-randomized controlled study was designed to compare the effects of addition of 50 mg of Magnesium sulphate (MgSO4) to Bupivacaine – fentanyl spinal anaesthesia. All adult patients undergoing lower abdominal and lower limb surgeries under Spinal Anaesthesia in the department of anaesthesiology at Vijayanagar Institute of Medical Sciences (VIMS), Bellary were included in the study. Results: The mean onset of sensory and motor blockade, peak sensory time were comparable between the two groups (p>0.05) however there was statistically significant difference between the groups with respect to duration of analgesia (128±8.6 min in fentanyl group and 136±13.1 min in fentanyl magnesium group, p=0.001) and the sedation score (p=0.001). Conclusions: Addition of magnesium sulfate (50 mg) to intrathecal fentanyl (25 ?g) for elective lower abdominal and limb surgeries has prolonged the duration of fentanyl analgesia without any significant side effects. Keywords: Bupivacaine, Fentanyl, Spinal anaesthesia, Sensory and motor blockad

Effect of addition of magnesium to local anesthetics for peribulbar block: A prospective randomized double-blind study

Background:Magnesium sulphate has been used along with local anesthetics in different regional blocks and found to be effective in decreasing the time of onset of the block and increasing the duration of the block.Objective:To evaluate the effect of addition of magnesium sulfate to standard local anesthetics mixture on the time for onset of the globe and lid akinesia for peribulbar block in ophthalmic surgeries.Materials and Methods:Sixty patients with American Society of Anesthesiologists status I to III undergoing ophthalmic surgery under peribulbar block were included in this study. Patients were randomized into two groups. Both the groups received 4.5 ml of 2% lidocaine, 4.5 ml of 0.5% bupivacaine with150 IU hyaluronidase. Group NS received normal saline 1 ml in the peribulbar block and Group MS, magnesium sulfate 50 mg in 1 ml normal saline. The onset of akinesia, satisfactory block and complications were observed by an independent observer.Results:Demographic data was statistically similar. In the Group NS at 3, 5, 10 and 15 min after the block, complete akinesia was seen in 0, 2, 11 and 28 patients respectively. In the Group MS, at 3, 5, 10 and 15 min after the block, complete akinesia was seen in 13, 23, 27 and 28 patients respectively. Patients received magnesium sulfate showed the statistically significant rapid onset of lid and globe akinesia than the control group till 10 min (P < 0.000). None of the patients needed a supplementary block and had complications during the surgery.Conclusion:Addition of 50 mg of magnesium sulfate to the lidocaine-bupivacaine mixture for peribulbar block decreases the onset of akinesia without any obvious side effect.

Addition of magnesium sulphate to ropivacaine for spinal analgesia in dogs undergoing tibial plateau levelling osteotomy

The aim of this blinded, randomised, prospective clinical trial was to determine whether the addition of magnesium sulphate to spinally-administered ropivacaine would improve peri-operative analgesia without impairing motor function in dogs undergoing orthopaedic surgery. Twenty client-owned dogs undergoing tibial plateau levelling osteotomy were randomly assigned to one of two treatment groups: group C (control, receiving hyperbaric ropivacaine by the spinal route) or group M (magnesium, receiving a hyperbaric combination of magnesium sulphate and ropivacaine by the spinal route). During surgery, changes in physiological variables above baseline were used to evaluate nociception. Arterial blood was collected before and after spinal injection, at four time points, to monitor plasma magnesium concentrations. Post-operatively, pain was assessed with a modified Sammarco pain score, a Glasgow pain scale and a visual analogue scale, while motor function was evaluated with a modified Tarlov scale. Assessments were performed at recovery and 1, 2 and 3 h thereafter. Fentanyl and buprenorphine were administered as rescue analgesics in the intra- and post-operative periods, respectively.Plasma magnesium concentrations did not increase after spinal injection compared to baseline. Group M required less intra-operative fentanyl, had lower Glasgow pain scores and experienced analgesia of longer duration than group C (527.0 ± 341.0 min vs. 176.0 ± 109.0 min). However, in group M the motor block was significantly longer, which limits the usefulness of magnesium for spinal analgesia at the investigated dose. Further research is needed to determine a clinically effective dose with shorter duration of motor block for magnesium used as an additive to spinal analgesic agents.

Conjugate Addition of Diboron Catalyzed by O-Monoacyltartaric Acids

O-3,5-Di(adamantan-1-yl)benzoyltartaric acid catalyzes the conjugate addition of bis(neopentyl glycolato)diboron to α,β-unsaturated ketones with good enantioselectivity. The addition of magnesium sulfate as a dehydrating agent and benzoic acid as a co-catalyst was found to be effective.

Assessment of 3-MCPD levels in coffee and coffee substitutes by simplified QuEChERS method

A new simplified QuEChERS method, with the use of PSA sorbent and without the addition of magnesium sulphate, was established for the determination of 3-monochloropropane-1,2-diol (3-MCPD) in coffee and coffee substitutes. The final extracts were derivatised with phenylboronic acid and analysed by gas chromatography-mass spectrometry. The recoveries were in the ranges of 90.5–107 % for all coffee types. The calculated limit of detection was 2.5 μg kg−1 and the linearity within the range of 2–200 ng mL−1. In real samples the highest level of 3-MCPD was detected in soluble coffee surrogates (average 135.6 μg kg−1), especially in those prepared from roasted spelt or barley, where they reached even up to 398.1 μg kg−1. The contents of 3-MCPD in natural instant and ground coffee samples were much lower with the average of 16.6 and 14.1 μg kg−1, respectively. Any impact of factors such as manufacturer or coffee origin was not observed.