{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:30Z","timestamp":1787071230262,"version":"build-2736575974"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>\n                      Evidence is inconclusive regarding the role of magnesium sulphate (MgSO\n                      <jats:sub>4<\/jats:sub>\n                      ) on the onset of sensory block in brachial plexus blocks (BPBs). A meta-analysis was conducted to assess the impact of adding MgSO\n                      <jats:sub>4<\/jats:sub>\n                      to local anaesthetics (LA) used in BPBs on the onset time of sensory block.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Medline, Embase, Google Scholar, and bibliography searches were consulted to identify randomised clinical trials using MgSO\n                      <jats:sub>4<\/jats:sub>\n                      versus control in BPBs. The primary outcome was the onset of sensory block. The secondary outcomes measured were duration of sensory and motor block, as well as the duration of analgesia. Continuous data were expressed as standard mean difference (SMD) with 95% confidence intervals (CI) and analysed using a random-effects model. Subgroup analysis was also performed based on magnesium dose. Study quality was assessed using a JADAD scoring system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty-two studies were included in this study. MgSO\n                      <jats:sub>4<\/jats:sub>\n                      led to a quicker onset of sensory block (n = 1768; N = 28; SMD = \u22121.00; 95% CI: \u22121.46, \u22120.55;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). MgSO\n                      <jats:sub>4<\/jats:sub>\n                      also led to a quicker onset of motor block (n = 1768; N = 28; SMD = \u22121.15; 95% CI: \u22121.62, \u22120.68;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.00001), and prolonged duration of analgesic effect (n = 1368; N = 21; SMD = 4.22; 95% CI: 3.36, 5.08;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.00001). Subgroup analysis showed that MgSO\n                      <jats:sub>4<\/jats:sub>\n                      doses of &gt;200 mg compared to \u2264200 mg prolonged the duration of sensory block (MD = 179.00 min vs 144.31 min) and motor block (MD = 145.26 min vs 116.52 min). It also showed that MgSO\n                      <jats:sub>4<\/jats:sub>\n                      &gt;200 mg led to a longer duration of analgesia compared to MgSO\n                      <jats:sub>4<\/jats:sub>\n                      \u2264200 mg (MD = 231.65 min vs 173.58 min).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Using MgSO\n                      <jats:sub>4<\/jats:sub>\n                      as an adjunct to LA in BPBs leads to a faster onset of sensory block. MgSO\n                      <jats:sub>4<\/jats:sub>\n                      also prolongs the duration of analgesia, with optimal doses likely being \u2264200 mg.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_100_25","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T16:00:32Z","timestamp":1763481632000},"page":"1324-1340","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Magnesium in brachial plexus blocks: A meta-analysis, meta regression, and trial sequential analysis"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3217-2424","authenticated-orcid":false,"given":"Sushil","family":"Pal","sequence":"first","affiliation":[{"name":"ST5 Resident Doctor, Department of Anaesthesia, Royal Liverpool University Hospital, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8684-9353","authenticated-orcid":false,"given":"Rasmeet Kaur","family":"Kainth","sequence":"additional","affiliation":[{"name":"ST7 Resident Doctor, Department of Anaesthesia, Alder Hey Children\u2019s Hospital, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6634-3387","authenticated-orcid":false,"given":"Rajiv","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Consultant, Department of Anaesthesia, University Hospitals of Liverpool Group, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4086-5692","authenticated-orcid":false,"given":"Arnab","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Consultant, Department of Anaesthesia, Royal Liverpool University Hospital, UK\/Goulburn Base Hospital, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4118-2651","authenticated-orcid":false,"given":"Rahul","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Medical Student, School of Medicine, University of Buckingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"38","DOI":"10.5435\/00124635-201201000-00005","article-title":"Brachial plexus blocks for upper extremity orthopaedic surgery","volume":"20","author":"Bruce","year":"2012","journal-title":"Am Acad Orthop Surg"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.3390\/jcm12041541","article-title":"Peripheral regional anesthesia using local anesthetics: Old wine in new bottles?","volume":"12","author":"Gasteiger","year":"2023","journal-title":"J Clin 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