A COMPARATIVE EVALUATION OF TWO DIFFERENT DOSES OF MAGNESIUM SULPHATE WITH BUPIVACAINE ON THE QUALITY OF SPINAL BLOCK AND POST OP ANALGESIA IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

Dr Rajshree Sharma; Dr Vandana Chugh

Volume : VII, Issue : IV, April - 2018

A COMPARATIVE EVALUATION OF TWO DIFFERENT DOSES OF MAGNESIUM SULPHATE WITH BUPIVACAINE ON THE QUALITY OF SPINAL BLOCK AND POST OP ANALGESIA IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

Dr Rajshree Sharma, Dr Vandana Chugh

Abstract :

Regional anaesthesia is preferred for caesarean sections ince it allows parturient to remain awake and participate in the birth of her babywhist avoiding the risk of general anaesthesia.¹Spinal Aaesthesia is easier to perform and has quick onset.Bupivacive is amide local anaesthetic which is commonly used for spinal and epidural anaesthesia.But, in recent years intrathecal adjuvants have gained poularitywith the aim of prolonging the block and better success rate.Magneium is avoltage gatedantagonist at the NMDA receptorin the spinal cord and this antagonism alters painprocessing and reduces the induction and maintenance of central sensitisation from nociceptive stimulation,. Therefore we conducted this study by adding 25mg and 50mg magnesium sulphate as adjuvant to bupivacaine in paturients undergoing caesarean section under spinal anaesthesia. METHOD Ninety ASA I–II etween the age group of 20–40 years undergoing LSCS were included in this prospective randomized double blind study. The patients were randomly allocated to one of the 3 groups of 30 each and spinal anaesthesia was administered . Group C recieved 2 ml 0.5% bupivacaine with 0.5 ml of normal saline, Group M25 received 2ml of 0.5% bupivacaine with 25mg of magnesium sulphate in 0.5 ml of normal saline and Group M50 received 2ml of 0.5% bupivacaine with 50mg of magnesium sulphate in 0.5 ml of normal saline. Intra–operatively standard monitoring was established with ECG, pulse oximetry and non invasive blood pressure . Recordings was noted every 5 min till 30 min, then every 10 minutes till 60 minutes and then hourly till 2 hours and then 2 hourly till 6 hoursRESULTS The maternal demographics profile of age, weight and height were similar among three groups. Also no difference was also noted in ASA category. The maternal demographics profile of age, weight and height were similar among three groups. Also no difference was also noted in ASA category. Duration of analgesia was 130.6+10.2min for control group,176.3+18.2min for M25 group and220.4+22.6 for M50 group(p= 0.000). Sensory duration was 116.7+8.7min for control, 158.1+17.5min for M25 and 201.1+19.2 min for M50 group(p= 0.000).Motor duration was 124.1+8.8 min for control, 168.2+17.5 for M25 and 211.3+20.6min for M50 group(p= 0.000). CONCLUSIONOur study showed that addition of 50 mg of magnesium sulphate to bupivacaine for intrathecal administration in lower segment caesarean section significantly increases the duration of sensory and motor block and duration of analgesia in comparison with 25 mg of magnesium sulphate and bupivacaine alone without increasing the incidence of side effects,