Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Clinical Research

Analgesic and hemodynamic effects of intravenous infusion of magnesium sulphate versus dexmedetomidine in patients undergoing bilateral inguinal hernial surgeries under spinal anesthesia: a randomized controlled study

Inas Farouk, Mohamed Mahmoud Hassan, Ahmed Mohamed Fetouh, Abd Elhay Abd Elgayed, Mona Hossam Eldin, Bassant Mohamed Abdelhamid

Downloads: 1
Views: 58


Spinal anesthesia is commonly employed during inguinal hernial surgeries. Its short duration may, however, be considered a limitation, especially for bilateral hernial repair. The aim of this research is to investigate the analgesic and hemodynamic effects of intravenous infusion of both MgSO4 and dexmedetomidine on patients undergoing bilateral inguinal hernia surgeries under spinal anesthesia.

This study was a prospective, randomized, double-blinded controlled trail. It included 60 male patients who had been scheduled for bilateral elective inguinal hernia surgery under spinal anesthesia at Kasr Al-Aini hospital. Patients were randomly allocated to one of three groups (n = 20 each) to receive 50 mL of 0.9% saline intravenous infusion of either dexmedetomidine 0.5 μ h-1 (Group D) or magnesium sulphate 15 h-1 (Group M) or normal saline (Group S). The primary outcome of this study was set as the total duration of analgesia Secondary outcomes were set as the onset and duration of sensory and motor blockade, perioperative hemodynamics, and the total 24 -h postoperative morphine consumption.

Durations of sensory and motor blockades as well as durations of analgesia were all significantly longer among patients in Group D (mean 2.2, 3.5, 5.8 -hs respectively) and Group M (mean 2.2, 3.3, 5.2 -hs respectively), in comparison to Group S (mean 1.5, 2.7, 3.9 -hs respectively). No significant differences were found in systolic or diastolic arterial blood pressure, heart rate oxygen saturation, cardiac output, or stroke volume among the study groups. Seven patients in group D and four patients in Groups M and S developed hypotension.

Intravenous infusion of either dexmedetomidine or MgSO4 with spinal anesthesia effectively improves the quality of spinal anesthesia and prolongs the duration of postoperative analgesia and decreases the 24 -h postoperative morphine consumption. Results also demonstrated that the use of dexmedetomidine resulted in a slightly longer duration of analgesia, whilst the use of MgSO4 resulted in slightly better hemodynamic stability.


Magnesium sulphate;  Dexmedetomidine;  Spinal anesthesia;  Bilateral inguinal herniorrhaphy


1 H Kehlet, PF White Optimizing anesthesia for inguinal herniorrhaphy: General, regional, or local anesthesia? Anesth Analg., 93 (2001), pp. 1367-1369

2 A.P. Morrison, J.M. Hunter, S.H. Halpern, A. Banerjee Effect of intrathecal magnesium in the presence or absence of local anaesthetic with and without lipophilic opioids: a systematic review and meta-analysis Br J Anaesth., 110 (2013), pp. 702-712

3 HES Moawad, MM Elawdy Efficacy of intrathecal dexmedetomidine in prevention of shivering in patients undergoing transurethral prostatectomy: a randomized controlled trial Egypt J Anaesth., 31 (2015), p. 178-6

4 A. Agrawal, S. Agrawal, Y.S. Payal Effect of continuous magnesium sulfate infusion on spinal block characteristics: A prospective study Saudi J Anaesth., 8 (2014), p. 78-4

5 A.M. Sousa, G.M. Rosado, S. Neto Jde, G.M. Guimarães, H.A. Ashmawi Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries: a double-blind randomized controlled trial J Clin Anesth., 34 (2016), pp. 379-384

6 M. Kumar, N. Dayal, R.S. Rautela, A.K. Sethi Effect of intravenous magnesium sulphate on postoperative pain following spinal anesthesia. A randomized double blinded controlled study Middle East J Anaesthesiol., 22 (2013), pp. 251-257

7 MB El Mourad, SK Arafa Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy–A prospective randomized study J Anaesthesiol Clin Pharmacol., 35 (2019), pp. 242-247

8 N. Nooraei, M.E. Dehkordi, B. Radpay, H. Teimoorian, S.A. Mohajerani Effects of intravenous magnesium sulfate and lidocaine on hemodynamic variables following direct laryngoscopy and intubation in elective surgery patients Tanaffos., 12 (2013), p. 57-5

9 S.H. Jung, S.K. Lee, K.J. Lim, et al. The effects of single-dose intravenous dexmedetomidine on hyperbaric bupivacaine spinal anesthesia J Anesth., 27 (2013), pp. 380-384

10 MH Lee, J.H. Ko, E.M. Kim, et al. The effects of intravenous dexmedetomidine on spinal anesthesia: comparision of different dose of dexmedetomidine Korean J Anesthesiol., 67 (2014), pp. 252-256

11 K. Elcicek, M. Tekin, I. Kati The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia J Anesth., 24 (2010), pp. 544-548

12 M.U. Santpur, G.M. Kahalekar, N Saraf, A Losari Effect of intravenous dexmedetomidine on spinal anaesthesia with 0.5% hyperbaric bupivacaine in lower abdominal surgeries: A prospective randomized control study Anesth Essays Res., 10 (2016), p. 497-5

13 M. Tekin, I. Kati, Y. Tomak, E. Kisli Effect of dexmedetomidine IV on the duration of spinal anesthesia with prilocaine: A double-blind, prospective study in adult surgical patients Curr Ther Res Clin Exp., 68 (2007), pp. 313-324

14 H. Zhang, M. Li, S.Y. Zhang, M. Fu, S.Y. Zhang Intravenous dexmedetomidine promotes spinal bupivacaine anesthesia and postoperative analgesia in lower limb surgery: a double-blind, randomized clinical CONSORT study Medicine (Baltimore)., 95 (2016), p. e2880

15 A. Thomas, M.V. Satyaprakash, L.B. Elakkumanan, P.U. Bidkar, S.K. Mishra Comparison of different regimens of intravenous dexmedetomidine on duration of subarachnoid block J Anaesthesiol Clin Pharmacol., 32 (2016), p. 497-4

16jcal anesthesia for elderly patients undergoing short transurethral procedures: a dose-finding study
Anesth Analg., 104 (2007), pp. 552-554

17 D. Jee, D. Lee, S. Yun, C. Lee Magnesium sulphate attenuates arterial pressure increase during laparoscopic cholecystectomy Br J Anaesth., 103 (2009), pp. 484-489

18 Z. Bao, C. Zhou, X. Wang, Y. Zhu Intravenous dexmedetomidine during spinal anaesthesia for caesarean section: A meta-analysis of randomized trials J Int Med Res., 45 (2017), pp. 924-928

19 F.W. Abdallah, A. Abrishami, R. Brull The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anathesia: A systematic review and meta analysis Anesth Analg., 117 (2013), pp. 271-278

20 I.A. Chan, J.G. Maslany, K.J. Gorman, J.M. O’Brien, W.P. McKay Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial Can J Anaesth., 63 (2016), pp. 569-576

21 S.H. Yun, J.C. Park, S.R. Kim, Y.S. Choi Effects of dexmedetomidine on serum interleukin-6,hemodynamic stability, and postoperative pain relief in elderly patients under spinal anesthesia Acta Med Okayama., 70 (2016), p. 37-7

22j Intravenous and Intrathecal Dexmedetomidine in Spinal Anesthesia: A Meta-Analysis CNS Neurosci Ther., 19 (2013), pp. 897-898

23 P.N. Shah, Y. Dhengle Magnesium sulfate for postoperative analgesia after surgery under spinal anesthesia Acta Anaesthesiol Taiwan., 54 (2016), pp. 62-63

24 F. Kahraman, A. Eroglu The effect of intravenous magnesium sulfate infusion on sensory spinal block and postoperative pain score in abdominal hysterectomy BioMed Research International., 3 (2014), pp. 1-5

25 HY Zhong, WP Zhang Effect of intravenous magnesium sulfate on bupivacaine spinal anesthesia in preeclamptic patients Biomed Pharmacotherapy., 108 (2018), p. 1289-5

26 E.T. Kılıça, G. Aydınb Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation Libyan J Med., 13 (2018), Article 1436845

27 M. Gozdemir, B. Usta, R.I. Demircioglu, B. Muslu, H. Sert, O.F. Karatas Magnesium sulfate infusion prevents shivering during transurethral prostatectomy with spinal anesthesia: a randomized, double-blinded, controlled study J Clin Anesth., 22 (2010), pp. 184-189

28 H. Omar, W.A. Aboella, M.M. Hassan, et al. Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery; (RCT) BMC Anesthesiol., 19 (2019), p. 190

602692b00e88253e7968ae7b rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections