Hemodynamic Effects of Intrathecal Magnesium Sulphate as an Adjuvant for Spinal Anesthesia in Pre-Eclamptic Patients

Abstract

Abstract Background pre-eclampsia is defined as a disorder that occurs in pregnancy after twenty weeks of gestation which manifests as hypertension and proteinuria with at least one maternal organ dysfunction involvement with an incidence of 5-10% of all pregnancies. Aim of the Work our study will examine the hemodynamic effects of adding two different doses of magnesium sulphate to bupivacaine in patients with severe preeclampsia undergoing caesarean section using spinal anesthesia. Patients and Methods: type of Study Prospective comparative study; it was done after approval of the Research Ethics Committee of Anesthesia, Intensive Care and Pain Management Department, Ain Shams University. Study Setting Ain Shams University Hospitals, Cairo, Egypt. Study Period 3 months. Study Population Pregnant females with severe preeclampsia undergoing caesarian section. Results results of this study indicated that the addition of magnesium sulfate at a dose of 100mg compared to the dose of 50 mg to bupivacaine showed that increasing the dose of magnesium sulfate had no significant hemodynamic effect (systolic blood pressure, diastolic blood pressure and heart rate) on severe preeclamptic patients undergoing caesarean section. But the addition of 100 mg magnesium sulfate lead to a significant delay in the onset of both sensory and motor blockade, and prolonged the duration of sensory and motor blockade compared to the addition of 50mg magnesium sulphate. Also there is no significant difference between the addition of 50 &100mg on shivering, nausea and vomiting, sedation, postoperative pain score (at 2,4 and 8 hours) and APGAR score (at 1 and 5 min). Conclusion the addition of magnesium sulfate at a dose of 100mg compared to the dose of 50 mg to bupivacaine in our study, showed that increasing the dose of magnesium sulfate had no significant hemodynamic effect (systolic blood pressure, diastolic blood pressure and heart rate) on severe preeclamptic patients undergoing caesarean section.