Effect of Magnesium sulfate on Ropivacaine under Ultrasound-Guided TAP Block in post- Cesarean Section patients.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 11
Abstract
Background and Aims: Post-Cesarean Section pain varies from moderate to severe and TAP (transverse abdominis plane) block has been used to manage the postoperative pain in abdominal surgeries but its effect of analgesia is of variable duration. Magnesium sulfate used as an adjuvant with local anesthetics in central neuroaxial and peripheral nerve blocks to prolong the analgesic effect. Our study is aimed to evaluate the effects of addition of magnesium sulfate to ropivacaine in the transverse abdominis plane block in post-cesarean section patients. Methods: This is double blind, randomized, clinical trial, conducted on 60 patients of ASA class I-II undergoing elective LSCS under spinal anaesthesia. Ultrasound-guided bilateral transverse abdominis plane (TAP) blocks administered after skin closure. Patients with bleeding disorders, sensitivity to the local anesthetics and magnesium sulfate, infection at site of injection were excluded. The patients were equally allocated into two groups, the group A (19 ml ropivacaine 0.2% with 1 ml normal saline), and the group B (19 ml ropivacaine 0.2% with 1 ml magnesium sulfate 500 mg), a total volume of 20 ml administered on each side. The patients’ characteristics, the level of pain score (visual analogue scale = VAS), rescue analgesic demand (Injection Diclofenac I.V. infusion), and complications if any were evaluated at 2, 6, 12, and 24 hours in postoperative period in the two groups. Results: The mean VAS scores of the patients two hours after surgery (the first post-block measurement) in A and B groups were 2.8 ± 0.6 and 2.6 ± 0.5 respectively. The scores reached 3.0 ± 0.8 and 2.7 ± 0.8 within the next 24 hours, respectively. Although the pain scores were generally lower at all hours in the B group, but it was not statistically significant. The rescue analgesic consumption increases with time in both groups though it was less in the group B than in group A at two hours after the block; however, it was not statistically significant. No complications were noted in both the groups. Conclusions: Results of our study showed that by adding magnesium sulfate to ropivacaine in TAP block does not prolong the duration of analgesia in post-Cesarean Section patients.
Authors and Affiliations
Dr. Mubina Begum
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