Effect of intra and postoperative magnesium sulphate infusion on postoperative pain

Evaluate the effect of intra and postoperative magnesium sulphate infusion on postoperative pain in abdominal surgery. Prospective double-blind randomized controlled study. Forty eight patients were randomly allocated to receive in the induction of anaesthesia, intraoperatively and six hours postoperatively either magnesium sulphate M Group [bolus 50mg/kg and 0.5g/h] or placebo [P Group]. Patients were given a dose of morphine [0.l mg/kg] IV, 45min before the end of surgery. Sedation, pain scores, cumulative morphine consumption and adverse effects were recorded up to 24 hours postoperatively. The duration of anaesthesia was similar in both groups. The time of the first demand of morphine was significantly longer in M Group then in P Group, respectively [18 +/- 5min vs 7 +/- lmin, p = 0.03]. Morphine consumption was significantly higher in control group than M group on the first postoperative day [52 +/- 4mg vs 30 +/- 3mg, p = 0.0002]. Pain scores were significantly lower in M group than in P group. Serum magnesium concentration was significantly higher in the M group. The frequency of side effects was similar in the two groups. The results of the study support magnesium sulphate as useful adjuvant for postoperative analgesia in abdominal surgery

Spinal anesthesia for endoscopic urological surgery- low dose vs. varying doses of hyperbaric bupivacaine

The aim of this study is to compare the efficiency of low dose vs. varying doses of hyperbaric bupivacaine in spinal anesthesia for endoscopic urological procedures. Sixty consecutive patients were studied in a randomized prospective manner. They received either of 5 [Gr I], 7.5 [Gr II] or 10 mg [Gr III] of hyperbaric bupivacaine 0.5% combined with 25 micro g of fentanyl, through a 25-gauge W hitacre spinal needle placed in the L3-L4 interspace. Characteristics of sensory and motor block, dose of ephedrine required, secondary effects, the patients, and the surgeons, satisfaction, were noted. The maximum number of blocked segments was 14 +/- 1 [Gr I], 15 +/- 2 [Gr II] and 16 +/- 2 [Gr III]. Time to T12 regression was significantly shorter for Gr I [53 +/- 13 min] than for Gr II [69 +/- 20 min] or Gr III [94 +/- 14 min]. Bromage 3 block was not found in Gr I compared to 4 patients in Gr II and 15 patients in Gr III. The duration of motor block was shorter in Gr 1[51 +/- 18 min] than in Gr II [86 +/- 19 min] and in Gr III [138 +/- 21 min]. Ephedrine was used for 16 patients in Gr III [9.8 +/- 12.2 mg], 5 patients in Gr II [3.7 +/- 7.8 mg] and 2 patients in Gr I [0.5 +/- 1.5 mg]. The difference is statistically significant between Gr III and the other groups. These results suggest that the use of a low dose of bupivacaine [5 mg] added to fentanyl [25 micro g] for endoscopic urological surgery, resulted in short-acting sensory block, without motor block and a lower incidence of cardiovascular side effects, as compared to either of 7.5 or 10 mg bupivacaine with 25 micro g fentanyl