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Indian Journal of Clinical Anaesthesia


Magnesium sulphate added as an adjuvant to intrathecal bupivacaine in patients with mild pregnancy induced hypertension undergoing caesarean section


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Author Details: Venkatesan K, Vijay Narayanan S, Iniya R, Rajalekshmi M

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 243

Article End Page : 250


Abstract

Background: Adequate analgesia following caesarean section decreases morbidity, ambulation, improves patient outcome and facilitates care of the newborn baby. Intrathecal Magnesium, an NMDA antagonist has been shown to prolong analgesia without significant side effect in healthy parturients. We therefore studied the effect of adding intrathecal Magnesium sulphate to Bupivacaine, Fentanyl in patient with mild pregnancy induced hypertension undergoing caesarean section.
Aim: To study and compare the effect of added Fentanyl 0.5cc (25 mcg) & Magnesium sulphate 0.1cc 50% (50mg) to 0.5% 2cc (10mg) Bupivacaine, in patients with pregnancy induced hypertension (PIH) undergoing elective Caesarean section under spinal anesthesia.
Materials and Methods: 60 patients undergoing elective caesarean section under spinal anaesthesia were randomly divided into three groups. Control group (N=20) received 0.5% 2cc (10mg) Inj.bupivacaine+0.6cc normal saline. Fentanyl group (N=20) received 0.5% 2cc (10mg) Inj.bupivacaine+0.5cc (25micgm) Inj.fentanyl+0.1cc normal saline. Magnesium sulphate group (N=20) received 0.5% 2cc (10mg) Inj.bupivacaine+0.5cc (25mcg) Inj.fentanyl+0.1cc 50% (50mg) magnesium sulphate. Onset, duration and recovery of sensory and motor block, duration of spinal anaesthesia, APGAR score and post operative analgesia duration were studied. Statistical analysis was done using univariate analysis, ANOVA and two group ‘T’ test. p<0.05 was taken as statistically signicant.
Results: Onset of sensory and motor blockade were delayed in the magnesium sulphate group which was significant. Duration of spinal anesthesia, motor block duration and post-operative analgesia were also significantly prolonged in Magnesium sulphate group.
Conclusion: Addition of magnesium sulphate to intrathecal bupivacaine is beneficial in antenatal women undergoing caesarean section, as it prolongs the motor blockade and duration of analgesia.

Key Words:
Fentanyl, Magnesium sulphate, NMDA antagonist, Bupivacaine, Pregnancy induced hypertension