Efficacy of Magnesium Sulphate as an Adjunct to Ropivacaine in Local Subcutaneous Infiltration for Postoperative Analgesia Following Lower Segmental Ceasfrean Section in Parturents under Spinal Anesthesia

Abstract

Introduction: Magnesium is an antagonist of NMDA receptors and associated ion channels. It is found in very small concentrations in the plasma and is chiefly an intracellular ion. It is suggested that magnesium has many important roles to play in nociception. An inverse relationship has been documented between the severity of pain with different painful medical and surgical conditions and the serum magnesium levels. Methodology: Patients were monitored for postoperative pain and any analgesic requirement for a period of 24 hours. Any patient complaining of pain or reporting VAS ≥ at any time was administered In tramadol 100 mg IV slowly over 2-3 minutes. If pain was not relieved after 30 minutes and patients still complained of pain, additional doses of Inj tramadol 50mg IV was given and this dose could be repeated every 30 minutes upto a total dose of 250 mg in 6 hourly and maximum of 400mg of Inj tramadol over 24 hours. Results: The number of patients who were administered 2nd, 3rd and 4th doses of rescue analgesics was significantly greater in group A as compared to group B. None of the patients in group B needed more than 4 doses of rescue analgesia while in group A, 5 patients were administered a rescue analgesic for 5th time. The study suggests that local infiltration of local anaesthetic agent alone or in conjunction with magnesium is safe. Conclusion: The addition of magnesium to local anaesthetics potentiates the effect of local anaesthetics and reduces the postoperative opioid requirement.