Magnesium sulphate as a perioperative analgesic in pre-eclamptic parturients undergoing cesarean section

ABSTRACT

Magnesium sulphate has been used for many years in management of pre-eclampsia and eclampsia. Recently magnesium is known to have an antinociceptive value as a physiological calcium antagonist of N, methyl D, aspartate [NMDA] receptors also it inhibits catecholamine release from the adrenargic nerve terminals. We designed this work to assess the prioperative analgesia induced by MgSO[4] on twenty adult preeclamptic "mild cases" parturient, ASA physical status I, II undergoing elective cesarean section. First group [n=20] received a bolus of MgSO[4] 20% 50 mgkg[-1] diluted in 100 ml of I.V. fluid over 20 minutes, then infused at a rate of 0.5 gmh[-1] discontinued 24 hours postoperatively, Second group [n=20] received equal volumes of physiological saline general anaesthesia used, rapid sequence induction with the patients to be considered full stomach, guarding against traumatic manipulation to the oedematous tissue in the time of intubation and also when urinary catheter was applied standard monitors was used, Visual analogue scale was used which is a scale from 1-10 where [0=no paim and 10=worst pain] to assess the pain, total analgesic requirement was calculated, Neonatal general condition was evaluated by using Apgar scoring, arterial blood gas analysis. Our results showed that, the magnesium usage in pre eclamptic parturients resulted in more or less normalization of the blood pressure and heart rate of mothers, allowing a safe induction conditions no significant increase in means of blood pressure or heart rate, no any significant effects on the neonates, The analgesic requirement was reduced. To conclude that MgSO[4] is a good analgesic adjuvant can be used preoperatively with the desired haemodynamic stability and without any neonatal harmful side effects