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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 4  |  Page : 239-246

Magnesium sulfate versus tramadol as adjuvants to local anesthetics in sciatic nerve block for lower extremities surgeries


1 Department of Anesthesiology and Intensive Care, Faculty of Medicine, Minia University, Minya, Egypt
2 Department of Anesthesiology and Intensive Care, Faculty of Medicine, Minia University, Minya; Department of Anesthesia, Minia University Hospital, Minya, Egypt
3 Department of Anesthesiology and Intensive Care, Minia Insurance Hospital, Minya, Egypt

Correspondence Address:
Haidy S Mansour
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Minia University Hospital, Minia University, Minia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_95_16

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Background The aim of this study was to compare the effect of addition of tramadol and magnesium sulfate as adjuvants to local anesthetics lidocaine 2% and bupivacaine 0.5% in sciatic nerve block classic posterior approach. Patients and methods A total of 90 ASA I or II patients, aged 17–50 years, scheduled for lower extremities surgeries under sciatic nerve block classic posterior approach were randomized into three equal groups. All groups received 20 ml of local anesthetics, which consisted of 10 ml bupivacaine 0.5% and 8 ml lidocaine 2% mixed with 2 ml saline in the control (C) group, 2 ml of 150 mg magnesium sulfate made in saline in the magnesium (M) group, and 2 ml of 100 mg tramadol in the tramadol (T) group. The onset and duration of both sensory and motor blocks, the intraoperative pain assessment by visual analogue scale, intraoperative analgesic requirements, postoperative pain by visual analogue scale, time to first analgesic request after surgery, postoperative diclofinac consumption, and adverse effects were assessed. Results The onsets of sensory and motor blocks were rapid in the M group, then C group, and lastly, T group. Much more time was needed for group T until sensory and motor blocks faded away followed by group M and then group C. There was a significant delay in the time of first analgesic request in groups M and T when compared with group C. There was a significant decrease in the total dose of diclofinac consumption in groups T and M in comparison with group C, where the patients consumed more analgesia. Conclusion Magnesium sulfate and tramadol as adjuncts to local anesthetics increase the duration of sensory and motor sciatic nerve block. The time for first rescue analgesia was longer in groups M and T, and they both showed decreased postoperative analgesic consumption.


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