Adding Magnesium Sulfate to Bupivacaine in Ultrasound Guided Paravertebral Block for Laparoscopic Cholecystectomy
Status:
Completed
Trial end date:
2021-02-15
Target enrollment:
Participant gender:
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 .