Adding Magnesium Sulfate to Bupivacaine in Ultrasound Guided Paravertebral Block for Laparoscopic Cholecystectomy

Summary

Laparoscopic cholecystectomy is one of the most commonly performed minimally invasive surgical procedures for the treatment of symptomatic cholelithiasis Laparoscopic cholecystectomy has clear benefits when compared with open surgery, but post-operative pain is still a common complaint after it The patient undergoing laparoscopic cholecystectomy suffers from severe post-operative pain, it can prolong hospital stay and lead to increased morbidity Post-operative laparoscopic cholecystectomy pain can be relieved by some methods pre-emptive analgesic regimens containing ketamine, regional anesthesia techniques including paravertebral block Paravertebral Block is a regional anesthetic and analgesic technique which may offer comparable analgesic effectiveness with minimal side effects Paravertebral Block has been used a lot in the last two decades, several studies show its efficacy in, thoracoscopic surgery and laparoscopic cholecystectomy .Paravertebral block is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina, resulting in ipsilateral somatic and sympathetic nerve blockade in multiple dermatomes above and below the site of injection .

Bupivacaine is a local anesthetic that is capable of producing prolonged high quality analgesia in the postoperative period It is shown that paravertebral block using bupivacaine significantly reduces pain score Many drugs have been used as adjuvants to local anesthetic in peripheral nerve block in order to augment its analgesic effect and prolong the duration of the block such as opioids and magnesium sulfate Many studies have reported safety and efficacy of adding magnesium to local anesthetics in various regional anesthetic procedures, such as intrathecal, epidural, caudal, brachial plexus blocks and intravenous regional anesthesia. Magnesium play a major role in central nociceptive transmission, modulation and sensitization of acute and chronic pain states due to its antagonistic effect on N-methyl D-aspartate (NMDA) receptors .

Conditions

• Laparoscopic Cholecystectomy

Interventions

DRUG

Bupivacain

local anesthetic agent

DRUG

magnesium sulfate

In the central nervous system , it has depressant effects, by antagonism at NMDA receptors and through inhibition of release of catecholamines

OTHER

saline

medical solution

Sponsors & Collaborators

• Mansoura University

  lead OTHER

Principal Investigators

• Ghada Fa Al-Rahamawy, MD · Professor of Anesthesia - Intensive Care Faculty of Medicine - Mansoura University

• Hesham Ah Abdel Mohaiemn, MD · Assistant Professor of Anesthesia - Intensive Care Faculty of Medicine - Mansoura University

• Marwa Ib Abdo, MD · Lecturer of Anesthesia Intensive Care Faculty of Medicine - Mansoura University

• Asmaa Ah Hossain, Ph.D · Residant in Anesthesia - Intensive Care Faculty of Medicine - Mansoura University

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

QUADRUPLE

Model

SEQUENTIAL

Eligibility

Min Age

20 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-07-15

Primary Completion

2020-09-10

Completion

2021-02-15

Countries

• Egypt

Study Locations