Effects of Magnesium Sulphate (MgSO4) Versus Fentanyl as an Adjuvant to Epidural Bupivacaine in Lower Abdominal Surgeries

Abstract

Background: In modern anaesthesia practice, a number of agents are used as adjuncts with epidural local anesthetics to achieve good perioperative hemodynamic stability as well as prolong the postoperative analgesia period. Among the different adjuvants, Fentanyl and Magnesium sulphate shows the promising results. Objectives: To study the effects of Magnesium Sulphate (MgSO4) versus Fentanyl as an Adjuvant to single-shot Epidural Plain Bupivacaine in Lower Abdominal Surgeries. Methods: It is a randomized controlled trail study, carried out in the Department of Anaesthesia, Analgesia, Palliative & Intensive Care Medicine, Dhaka Medical College Hospital Dhaka. Study populations were patients of ASA Status I-II planned for lower abdominal surgery under single-shot epidural anaesthesia. Study populations were randomly allocated into one of the three groups, of 25 each- group C, M&F. Group C-Patients received plain bupivacaine 0.5% 20 ml. Group M - Patients plain bupivacaine 0.5%(19 ml)+500 mg magnesium sulphate (1ml) and group F received plain bupivacaine 0.5% (19 ml)+50μg Fentanyl (1ml). Data were processed and analyzed by SPSS version 22.0. Results: It was found that the onset of sensory block at T8 was faster in Group M and F (14.2±2.5 min & 13.8±2.2 min) than Group C (18.5±3.1 min). On comparison of the required time to achievement of sensory loss between groups, required time was 11-15 minutes in 12(48.0%) patients of Group-M, 15(60.0%) in group F versus 16-20 minutes in 12(48.0%) patients of Group-C. The result was significant (*p-value < 0.05). In this study duration of sensory block was longer in Group-M ˃Group-F˃ group C. Result was significant between groups (p<0.01). But the motor block was almost similar between groups. No statistically significant difference was seen in between groups. It was evident that intensity of pain was lower up to 6 hrs. After anaesthesia, following that pain increases and analgesic also required in all groups, comparatively ........