FENTANYL VERSUS MAGNESIUM SULPHATE AS ADJUVANT TO HYPERBARIC BUPIVACAINE IN SPINAL ANESTHESIA FOR ELECTIVE CESAREAN SECTIONS

Abstract

ABSTRACT Background: Subarachnoid block achieved a wide spread popularity as a simple and effective method of anesthesia for elective cesarean sections.The use of intrathecal adjuvants has gained popularity, with the intention of reducing the dose of local anesthetics, maintaining hemodynamic stability and delaying the onset of pain during the postoperative period The present study compared between fentanyl and magnesium sulphate as adjuvant to hyperbaric bupivcaine in subarachnoid block for patients undergoing elective cesarean sections. Subject and Methods: A total of 56 consented pregnant females undergoing elective cesarean sections, ASA grade I and II, were randomized into two groups of 28 patients each. Group F received 12.5 mg of intrathecal 0.5% hyperbaric bupivacaine ( 2.5 ml ) + 12.5 μg (0.25 mL) fentanyl + .75 ml normal saline, Group M 12.5 mg of intrathecal 0.5% hyperbaric bupivacaine ( 2.5 ml ) + 100 mg (1 ml) magnesium sulfate. The two groups were assessed for character of the block, haemodynamic changes, duration of post operative analgesia, the side effects. Results: The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anesthesia and motor block were significantly longer in the magnesium group. Total analgesic dose requirement was less in Group M. Hemodynamic parameters were comparable in the two groups. Intrathecal magnesium caused minimal side effects. Conclusion: The addition of magnesium sulfate 100 mg to bupivacaine for sub-arachnoid block in patients undergoing elective cesarean section prolongs the duration of analgesia and reduces postoperative analgesic requirements without additional side effects and adverse neonatal outcomes. Key words: Subarachnoid block, magnesium sulfate, fentanyl, post operative analgesia, elective cesarean sections.