A Comparative Study between the Effect of Addition of MgSO4 or Dexamethasone to Bupivacaine on the Prolongation of Ultrasound-Guided Quadratus Lumboram Block in Open Abdominal Surgeries

Abstract

Abstract Background Operations rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using regional anethesia. Aim of the Work The aim of this study was to assess the analgesic effect of addition dexamethasone or magnesium with bupivacaine in ultrasound-guided QLB to prolong it’s duration in patients undergoing open abdominal surgeries in the early postoperative period regarding pain relief, provision of comfort, and improved respiratory functions. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients undergoing open abdominal surgeries were included in the study, and were divided into three groups (n = 22; each); group M, D and group C. In Group A, patients (n = 22) received 20 ml bupivacaine 0.25% plus 5 ml of 10% MgSO. In group B, patients (n = 22) received 20 ml bupivacaine 0.25% plus 8 mg dexamethasone (2 ml) plus 3 ml 0.9% NaCl. In group C (control), patients (n = 22) received 20 ml bupivacaine plus 5 ml 0.9% NaCl. Results The thesis proved that the addition of either magnesium sulfate or dexamethasone to bupivacaine 0.25% in ultrasound guided QLB for open abdominal surgeries hastened the onset, prolonged the duration of sensory block, increased post-operative analgesia and decreased rescue analgesia needed without increasing the risk of adverse effects, with Dexamethasone showed better results. Conclusion The addition of either 500 mg magnesium sulfate or 8 mg dexamethasone to 20 ml bupivacaine 0.25% in ultrasound guided quadratus lumborum block for open abdominal surgery prolonged the duration of analgesia significantly and decreased the postoperative analgesic requirement. Hence, this study suggests that either magnesium or dexamethasone may be a useful alternative as an adjuvant to long-acting local anesthetics for quadratus lumborum nerve block with Dexamethasone showed better results.