Clinical Trial – Effect of Intravenous Magnesium on Post-spinal Fentanyl Induced Pruritus Incidence
Introduction: Adding opioids to local anesthetic solutions leads to enhanced anesthesia and
provide postoperative analgesia. Intrathecaly injected opioids have some side effects,
though. One of them is pruritus. Objective: We designed a randomized, double‐blinded,
placebo‐controlled study to evaluate prophylactic impact of continuous IV Magnesium 10mg/kg
over 30 minutes on intrathecal fentanyl‐induced pruritus start at the end of the operation.
Methods: ASA I‐II Patient’s candidate for orthopedic operations under spinal anesthesia
(10‐15mg hyperbaric bupivacaine and 25 µg fentanyl intrathecal) and will be divided randomly
into two groups:
Control group (Placebo group): bolus 100 ml nacl 0.9% at end of surgery Study group (Mg ++
group): (continuous IV Magnesium 10mg/kg in 100 ml Nacl0.9% over 30 minutes at end of
surgery).
Study outcome:
1. Hemodynamics: Systolic blood pressure, Mean arterial blood pressure, pulse rate, O2
saturation will be recorded in 5 min,10 min,30 min,60 min and every one hour till 6
hours after the operation.
2. Pruritus Patients were asked about existence (present=1,no=0), severity (mild=1,
modret=2, sever =3) and site of pruritus (Face(trigeminal) =1, neuroaxial(dermatome)=2),
1,2,4, and 6 hours after operation. Incidence of pruritus total group incidence %.
3. The incidence of PONV.
Clinical Trial – Plethysmographic Variability Index in Post Spinal Anesthesia Hypotension in Cesarean Section
– Full term pregnant female patients presented for elective C.S for single viable fetus
will be included in this study.
– Before anesthesia, the patient will be attached to a monitor of: ECG , heart rate, non
invasive blood pressure, pulse taximeter applied on the index finger of the limb not
attached to the blood pressure cuff, pulse oximetry and plethysmographic variability
index (PVI) and perfusion index (PI) will be taken by (Massimo radical 7, Massimo corp.
USA). Measures will be recorded every 5 minutes preoperative.
– Patients with PVI <15 will be excluded from the study.
- Patients with PVI > 15 are started on intravenous infusion of warm ringer lactate
solution via suitable pore intravenous cannula to reach target of PVI <15 or a total 1
liter of ringer lactate.
- The patients in which the PVI is corrected by fluid to level below 15 will be Group (C)
or corrected group. Patients in which intravenous fluid administration did not result
any change in PVI or changed but still higher than 15 will be Group (NC) or non
corrected group.
After preoperative preparation patient is shifted to operating theater, with all monitors
applied. She will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg
plus 25 mic fentanyl. After giving anesthesia and positioning for surgery with a left lateral
tilt of 15 degrees,
Clinical Trial – Comparison of Clorotekal and Bupivacaine for Short Obstetric Surgery
The following obstetric procedures are commonly performed with spinal anesthesia on labor and
delivery: bilateral tubal ligation, external cephalic version, cerclage insertion, cerclage
removal, minimally invasive fetal surgery, and evacuation of retained products of conception.
Bupivacaine is currently the standard spinal medication for these procedures because of its
long history of safe use, its low incidence of transient neurologic symptoms, and its ability
to provide a dependable, dense block with a high degree of maternal satisfaction. While
bupivacaine has the aforementioned advantages, it unfortunately has a long duration of
action, up to 240-380 minutes, which far exceeds the time necessary to complete most
obstetric procedures. Clorotekal®, the first Food and Drug Administration approved
chloroprocaine solution created for spinal injection, is a potential alternative. When
compared with bupivacaine spinals, chloroprocaine spinals have been shown to facilitate
clinically significant shorter times to resolution of motor and sensory block, first
ambulation, micturition, and discharge readiness. The objective of this study is to determine
if a strategy of spinal anesthesia with chloroprocaine will reduce the duration of motor
block, compared with equivalent block with hyperbaric bupivacaine..
Clinical Trial – 3 Local Anesthetics for Spinal Anesthesia in Primary Total Hip Arthroplasty
Spinal anesthesia is commonly utilized for hip replacement surgery. Different medications
used for spinal anesthesia work for different lengths of time. This study will compare three
different spinal anesthesia medications in patients having hip replacement surgery to see if
patients are able to get out of bed and walk earlier after surgery with one medication versus
the others.