Magnesium Sulphate added as an Adjuvant to Intrathecal Bupivacaine in Patient with Mild Pregnancy Induced Hypertension Undergoing Caesarean Section

BACKGROUND: Adequate analgesia following caesarean section decreases Morbidity, Ambulation, Improve patient outcome and facilitate 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. MATERIALS AND METHODS: After obtaining ethical committee approval from Government Kilpauk Medical College, Chennai, 60 patients with ASA I & II between the age group of 18 -35 undergoing elective caesarean section under spinal anesthesia were randomly divided in to three groups. Group C – Control group, (N=20) patients 0.5% 2cc (10mg) Bupivacaine +0.6cc normal saline Group F-Fentanyl group, (N=20) patients 0.5% 2cc (10mg) Bupivacaine +0.5cc (25micgm) Fentanyl +0.1cc normal saline. Group M - Magnesium sulphate group, (N=20) patients 0.5% 2cc (10mg) Bupivacaine+0.5cc (25micgm) Fentanyl +0.1cc 50% (50mg) magnesium sulphate. Onset, Duration and recovery of sensory and motor block duration of spinal anesthesia, APGAR score and post operative analgesia duration were studied. RESULTS: Onset of sensory and motor blockade was delayed in the magnesium sulphate group duration of spinal anesthesia and motor block duration is prolonged in Magnesium sulphate group.(189.40 minutes) post operative analgesia was significantly prolonged in the Magnesium sulphate group when compared to control group(403.65vs 222.45minutes) hemodynamic parameter at 1,5,10,15,20,30 min were evaluated. CONCLUSION: There is delay in onset of sensory and motor blockade with use of Magnesium sulphate. However there is prolonged motor blockade and duration of analgesia overlaps well in to the post operative period. This is beneficial for the patient for post operative analgesia. APGAR Score not affected between the groups