Adding Magnesium Sulfate to Bupivacaine for Ilioinguinal and Iliohypogastric Nerve Block

Study Overview
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Brief Summary
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Regional block of ilioinguinal and iliohypogastric (IIIH) nerves has been applied to provide postoperative analgesia after inguinal hernia repair. Magnesium sulfate (MgSo4) blocks N-methyl-d-aspartate receptors, and that is why, it was used as an adjuvant to the local anesthetic (LA) in different anesthetic approaches. Although the prolongation in postoperative duration resulting from the addition of MgSO4 to LA was significant in some literature studies, it was insignificant in others. This study was designed to investigate the adjunctive effect of MgSo4 when added to bupivacaine for IIIH blockade on the postoperative analgesic duration as a primary outcome and on the verbal rating scale (VRS) scores, analgesic consumption, and hemodynamics as secondary outcomes.

Detailed Description
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Regional block of ilioinguinal and iliohypogastric (IIIH) nerves has been applied to provide postoperative analgesia after inguinal hernia repair. Magnesium sulfate (MgSo4) blocks N-methyl-d-aspartate receptors, and that is why, it was used as an adjuvant to the local anesthetic (LA) in different anesthetic approaches. Although the prolongation in postoperative duration resulting from the addition of MgSO4 to LA was significant in some literature studies, it was insignificant in others. This study was designed to investigate the adjunctive effect of MgSo4 when added to bupivacaine for IIIH blockade on the postoperative analgesic duration as a primary outcome and on the verbal rating scale (VRS) scores, analgesic consumption, and hemodynamics as secondary outcomes. Patients were divided into two groups of 45 patients each by means of coded envelopes according to the LA used for IIIH blockade. In the first group (control group), patients received 10 ml 0.5% isobaric bupivacaine plus 1 ml normal saline for IIIH blockade, whereas in the second group (MgSo4 group), 10 ml 0.5% isobaric bupivacaine and 1 ml of MgSo4 10% were prepared. All the patients received intrathecal 3 ml 0.5% hyperbaric bupivacaine, and then, IIIH blockade was performed under ultrasound guidance according to the group. Postoperatively, VRS scores,analgesic duration, and any complication were recorded.

Official Title
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Efficacy of Adding Magnesium Sulfate to Bupivacaine for Ilioinguinal and Iliohypogastric Nerve Block in Acute Postherniorrhaphy Pain

Conditions
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Magnesium Sulfate Causing Adverse Effects in Therapeutic Use

Intervention / Treatment
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* Other: normal saline
* Drug: MgSo4


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult male American Society of Anesthesiologists physical status I or II Exclusion Criteria: Patients with body mass index greater than or equal to 35 kg/m2 allergy to the study drugs on chronic analgesics or drug containing magnesium
Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: control group<br>10-ml 0.5% isobaric bupivacaine and 1ml normal saline were prepared for IIIH blockade | Other: normal saline<br>* 10-ml 0.5% isobaric bupivacaine and 1ml normal saline were prepared for IIIH blockade<br>* Other names: Control group;|
| Active Comparator: MgSo4 group<br>10 ml 0.5% isobaric bupivacaine and 1ml of MgSo4 10% (100 mg) were used. | Drug: MgSo4<br>* 10 ml 0.5% isobaric bupivacaine and 1ml of MgSo4 10% (100 mg) were used<br>* Other names: Magnesium Sulphate;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 2 hours postoperatively | 
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 4 hours postoperatively | 
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 6 hours postoperatively | 
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 12 hours postoperatively | 
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 18 hours postoperatively | 
| Postoperative incisional pain | Postoperative incisional pain was evaluated by VRS | 24 hours postoperatively |