Investigating the Beneficial Effects of Adding Intrathecal Magnesium to Spinal Anesthetic Solution in Lower Limb Orthopedic Surgeries: A Systematic Review

Introduction: The safety of administration of intrathecal magnesium has been proven in many studies and this drug has no toxic effects in histopathological analyses. For example, in one study, the effects of intrathecal magnesium sulfate administration in preventing spinal cord ischemia during aortic cross-clamp have been proven and no histopathological damage has been observed. The aim of this systematic review is to investigate the beneficial effects of adding intrathecal magnesium to spinal anesthetic solution in lower limb orthopedic surgeries. Methodology: The present study is a systematic review study that was conducted in the first quarter of 2023 at Tabriz University of Medical Sciences. At first, the basic keywords to search for articles published in all English-language databases were determined by both researchers of this study; These keywords include: magnesium, magnesium sulfate, intraspinal, spinal, intrathecal, anesthetic solution, lidocaine, bupivacaine, surgery, orthopedics, lower limb, pain, pain intensity, hemodynamic status, blood pressure, systolic, diastolic, opioid , opioid use, analgesic, analgesia, pain control, pain management, severe pain, acute and painful pain. Results: The results indicated that the addition of intrathecal magnesium leads to a significant reduction in pain intensity after lower limb orthopedic surgeries; This means that whenever magnesium sulfate is injected into the spinal cord following the injection of intrathecal anesthetic, the intensity of pain after surgery is significantly reduced and the use of intrathecal magnesium leads to optimal and useful pain management. Conclusion: Our study showed that adding 100 mg of magnesium sulfate to spinal anesthesia can prolong the duration of analgesia without side effects after orthopedic procedures. Also, the safety of higher intrathecal dose of magnesium sulfate was shown in this study.