Intrathecal Magnesium for Same-day-surgery

NCT ID: NCT01794247

Last Updated: 2014-03-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-04-30

Study Completion Date

2014-03-31

Brief Summary

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5% hyperbaric lidocaine has lost its usefulness for same-day-surgery (SDS) anaesthesia because it has been blamed responsible for the so-called transitory neurological syndrome (TNS). This entity appears particularly in patients operated on lithotomy and knee arthroscopy position and obese patients. It is a benign, moderately painful (grade 3-4 out of 10) and self-limited in time, but disturbing enough to be avoided in same-day-surgery cases. Other local anesthetics are not competitive with general anesthesia in time to be discharged home from the SDS unit. The magnesium ion is well-known for its protective properties on cells with electrical activity. The objective is to confirm that the magnesium ion added as adjuvant to intrathecal (IT) lidocaine may antagonize TNS incidence. If this hypothesis could be confirmed, the practical and theoretical consequences would be far-reaching.

The method to achieve our objective would be a double-blinded randomized clinical trial considering two groups of intrathecal lidocaine: with and without added IT magnesium.

Detailed Description

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Conditions

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Transient Neurologic Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Intrathecal magnesium

Intrathecal magnesium sulfate 15% 0,5 mL (75 mg) is added to lidocaine 5% 1 mL (50 mg)as anesthetic adjuvant

Group Type EXPERIMENTAL

Magnesium sulfate

Intervention Type DRUG

Lidocaine

Intervention Type DRUG

Intrathecal fentanyl

Intrathecal fentanyl 0.5 mL (25 micrograms)is added to lidocaine 5% 1 ML (50 mg) as anesthetic adjuvant

Group Type ACTIVE_COMPARATOR

Fentanyl

Intervention Type DRUG

Lidocaine

Intervention Type DRUG

Interventions

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Magnesium sulfate

Intervention Type DRUG

Fentanyl

Intervention Type DRUG

Lidocaine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Same day surgery patients
* Operated in lithotomy or arthroscopy position or obese patients

Exclusion Criteria

* American Society of Anesthesia 3 or 4 patients
* Younger than 18 or elder than 80 years-old
* Active lumbar pain
* Any short of chronic neurologic disease
* Any short of myopathy
* Pregnant women
* Previous history of allergic or toxic reaction to lidocaine, magnesium or fentanyl
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Castilla-La Mancha

OTHER

Sponsor Role collaborator

Hospital General de Ciudad Real

OTHER

Sponsor Role lead

Responsible Party

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Javier Pascual-Ramirez

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Javier Pascual-Ramírez, Md, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital general Universitario de Ciudad Real

Locations

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Hospital General universitario de Ciudad Real

Ciudad Real, Castille-La Mancha, Spain

Site Status

Hospital General Universitario de Ciudad Real

Ciudad Real, Ciudad Real, Spain

Site Status

Countries

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Spain

References

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Jabalameli M, Pakzadmoghadam SH. Adding different doses of intrathecal magnesium sulfate for spinal anesthesia in the cesarean section: A prospective double blind randomized trial. Adv Biomed Res. 2012;1:7. doi: 10.4103/2277-9175.94430. Epub 2012 May 11.

Reference Type BACKGROUND
PMID: 23210066 (View on PubMed)

Nath MP, Garg R, Talukdar T, Choudhary D, Chakrabarty A. To evaluate the efficacy of intrathecal magnesium sulphate for hysterectomy under subarachnoid block with bupivacaine and fentanyl: A prospective randomized double blind clinical trial. Saudi J Anaesth. 2012 Jul;6(3):254-8. doi: 10.4103/1658-354X.101217.

Reference Type BACKGROUND
PMID: 23162399 (View on PubMed)

Khezri MB, Yaghobi S, Hajikhani M, Asefzadeh S. Comparison of postoperative analgesic effect of intrathecal magnesium and fentanyl added to bupivacaine in patients undergoing lower limb orthopedic surgery. Acta Anaesthesiol Taiwan. 2012 Mar;50(1):19-24. doi: 10.1016/j.aat.2012.03.001. Epub 2012 Mar 31.

Reference Type BACKGROUND
PMID: 22500909 (View on PubMed)

Shukla D, Verma A, Agarwal A, Pandey HD, Tyagi C. Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011 Oct;27(4):495-9. doi: 10.4103/0970-9185.86594.

Reference Type BACKGROUND
PMID: 22096283 (View on PubMed)

Khalili G, Janghorbani M, Sajedi P, Ahmadi G. Effects of adjunct intrathecal magnesium sulfate to bupivacaine for spinal anesthesia: a randomized, double-blind trial in patients undergoing lower extremity surgery. J Anesth. 2011 Dec;25(6):892-7. doi: 10.1007/s00540-011-1227-z. Epub 2011 Sep 18.

Reference Type BACKGROUND
PMID: 21928127 (View on PubMed)

Mebazaa MS, Ouerghi S, Frikha N, Moncer K, Mestiri T, James MF, Ben Ammar MS. Is magnesium sulfate by the intrathecal route efficient and safe? Ann Fr Anesth Reanim. 2011 Jan;30(1):47-50. doi: 10.1016/j.annfar.2010.12.005. Epub 2011 Jan 13.

Reference Type BACKGROUND
PMID: 21236623 (View on PubMed)

Ouerghi S, Fnaeich F, Frikha N, Mestiri T, Merghli A, Mebazaa MS, Kilani T, Ben Ammar MS. The effect of adding intrathecal magnesium sulphate to morphine-fentanyl spinal analgesia after thoracic surgery. A prospective, double-blind, placebo-controlled research study. Ann Fr Anesth Reanim. 2011 Jan;30(1):25-30. doi: 10.1016/j.annfar.2010.10.018. Epub 2010 Dec 8.

Reference Type BACKGROUND
PMID: 21145193 (View on PubMed)

Malleeswaran S, Panda N, Mathew P, Bagga R. A randomised study of magnesium sulphate as an adjuvant to intrathecal bupivacaine in patients with mild preeclampsia undergoing caesarean section. Int J Obstet Anesth. 2010 Apr;19(2):161-6. doi: 10.1016/j.ijoa.2009.08.007. Epub 2010 Feb 18.

Reference Type BACKGROUND
PMID: 20171080 (View on PubMed)

Ghrab BE, Maatoug M, Kallel N, Khemakhem K, Chaari M, Kolsi K, Karoui A. [Does combination of intrathecal magnesium sulfate and morphine improve postcaesarean section analgesia?]. Ann Fr Anesth Reanim. 2009 May;28(5):454-9. doi: 10.1016/j.annfar.2009.03.004. Epub 2009 May 7. French.

Reference Type BACKGROUND
PMID: 19427159 (View on PubMed)

Unlugenc H, Ozalevli M, Gunduz M, Gunasti S, Urunsak IF, Guler T, Isik G. Comparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery. Acta Anaesthesiol Scand. 2009 Mar;53(3):346-53. doi: 10.1111/j.1399-6576.2008.01864.x. Epub 2009 Jan 23.

Reference Type BACKGROUND
PMID: 19173689 (View on PubMed)

Jellish WS, Zhang X, Langen KE, Spector MS, Scalfani MT, White FA. Intrathecal magnesium sulfate administration at the time of experimental ischemia improves neurological functioning by reducing acute and delayed loss of motor neurons in the spinal cord. Anesthesiology. 2008 Jan;108(1):78-86. doi: 10.1097/01.anes.0000296109.04010.82.

Reference Type BACKGROUND
PMID: 18156885 (View on PubMed)

Arcioni R, Palmisani S, Tigano S, Santorsola C, Sauli V, Romano S, Mercieri M, Masciangelo R, De Blasi RA, Pinto G. Combined intrathecal and epidural magnesium sulfate supplementation of spinal anesthesia to reduce post-operative analgesic requirements: a prospective, randomized, double-blind, controlled trial in patients undergoing major orthopedic surgery. Acta Anaesthesiol Scand. 2007 Apr;51(4):482-9. doi: 10.1111/j.1399-6576.2007.01263.x.

Reference Type BACKGROUND
PMID: 17378788 (View on PubMed)

Ozalevli M, Cetin TO, Unlugenc H, Guler T, Isik G. The effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia. Acta Anaesthesiol Scand. 2005 Nov;49(10):1514-9. doi: 10.1111/j.1399-6576.2005.00793.x.

Reference Type BACKGROUND
PMID: 16223399 (View on PubMed)

Buvanendran A, McCarthy RJ, Kroin JS, Leong W, Perry P, Tuman KJ. Intrathecal magnesium prolongs fentanyl analgesia: a prospective, randomized, controlled trial. Anesth Analg. 2002 Sep;95(3):661-6, table of contents. doi: 10.1097/00000539-200209000-00031.

Reference Type BACKGROUND
PMID: 12198056 (View on PubMed)

Saeki H, Matsumoto M, Kaneko S, Tsuruta S, Cui YJ, Ohtake K, Ishida K, Sakabe T. Is intrathecal magnesium sulfate safe and protective against ischemic spinal cord injury in rabbits? Anesth Analg. 2004 Dec;99(6):1805-1812. doi: 10.1213/01.ANE.0000138039.04548.3D.

Reference Type BACKGROUND
PMID: 15562076 (View on PubMed)

Other Identifiers

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2012-004538-40

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MAGLIDIT-12

Identifier Type: -

Identifier Source: org_study_id

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