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document
The effect of magnesium added to levobupivacaine for femoral nerve block on postoperative analgesia in patients undergoing ACL reconstruction . PURPOSE The aim of this prospective randomised double-blind study is to investigate the effect of magnesium added to local anaesthetics on postoperative VAS scores , total opioid consumption , time to first mobilisation , patient satisfaction and rescue analgesic requirements in arthroscopic ACL reconstruction surgery . METHODS A total of 107 American Society of Anaesthesiologists physical status grade I and II patients between 18 and 65 years of age who were scheduled to undergo elective anterior crucial ligament ( ACL ) reconstruction with hamstring autografts were enrolled in the study . The patients were randomly allocated to Groups L ( n = 51 ) and LM ( n = 56 ) using the closed-envelope method . Group LM was administered 19 ml of 0.25 % levobupivacaine and 1 ml of 15 % magnesium sulphate , while Group L was administered 20 ml of 0.25 % levobupivacaine for femoral blockade . General anaesthesia was administered using laryngeal airway masks following neural blockade in both groups . The patients were evaluated for heart rate and mean arterial pressure , oxygen saturation , visual analogue score ( VAS ) , verbal rating scale ( VRS ) , rescue analgesic requirements , total opioid consumption , side effects and time to first mobilisation at the 1st , 2nd , 4th , 6th , 12th and 24th hours postoperatively . RESULTS There was no statistically significant difference in terms of demographic data , mean arterial pressure , heart rate or oxygen saturation between groups . The area under the curve VAS and VRS scores were lower at 4 , 6 , 12 and 24 h in Group LM ( p = 0.001 , p = 0.016 , respectively ) . The rescue analgesic requirement and the total opioid consumption were significantly lower in Group LM ( p = 0.015 , p = 0.019 , respectively ) . The time to first mobilisation and the Likert score ( completely comfortable ; quite comfortable ; slight discomfort ; painful ; very painful ) were higher , and the block onset time was lower in Group LM ( p = 0.014 and p = 0.012 , respectively ) . There was no difference in terms of side effects . CONCLUSIONS The addition of magnesium to levobupivacaine prolongs the sensory and motor block duration without increasing side effects , enhances the quality of postoperative analgesia and increases patient satisfaction ; however , the addition of magnesium delays the time to first mobilisation and decreases rescue analgesic requirements .
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Intervention_Pharmacological
magnesium
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Intervention_Pharmacological
levobupivacaine
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Intervention_Pharmacological
magnesium
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Intervention_Pharmacological
levobupivacaine
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Intervention_Pharmacological
magnesium sulphate
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Intervention_Pharmacological
0.25 % levobupivacaine
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Intervention_Pharmacological
magnesium
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Outcome_Physical
heart rate and mean arterial pressure
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Outcome_Physical
oxygen saturation
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Outcome_Physical
visual analogue score ( VAS ) , verbal rating scale ( VRS )
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Outcome_Other
rescue analgesic requirements
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Outcome_Other
total opioid consumption
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Outcome_Physical
demographic data , mean arterial pressure , heart rate or oxygen saturation
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Outcome_Physical
area under the curve VAS and VRS scores
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Outcome_Physical
rescue analgesic requirement and the total opioid consumption
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Outcome_Physical
time to first mobilisation and the Likert score
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Outcome_Other
block onset time
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Participant_Condition
ACL reconstruction
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Participant_Sample-size
107
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Participant_Age
between 18 and 65 years of age
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Participant_Condition
elective anterior crucial ligament ( ACL ) reconstruction