THE EFFECT OF PREOPERATIVE SINGLE SHOT DOSE OF EPIDURAL MAGNESIUM SULPHATE OR DEXAMETHASONE AS ADJUVANTS TO LOCAL ANESTHESIA

Different drugs could be used to prolong the duration of regional anesthesia and postoperative pain relief, together with decreasing the analgesic requirements. This study was undertaken to test whether a reduction in postoperative pain and analgesic consumption could be achieved by preoperative administration of epidural dexamethasone or magnesium with local anesthetic in patients undergoing major abdominal cancer surgery under combined general- epidural anesthesia. Patients and Methods: Three groups of patients (20 patients each) undergoing major abdominal surgery were randomly assigned; Study group I received 0.25% bupivacaine12 ml, morphine 2mg, and magnesium sulphate 50mg; study group II received epidural injection of 0.25% bupivacaine 12mL, morphine 2mg, and dexamethasone 6mg; and study group III received 0.25% bupivacaine12ml and morphine 2mg in equal volumes and was considered a control group. Intraoperative haemodynamic changes, postoperative visual analogue scale (VAS) at rest and with movement, intraoperative and postoperative opioid consumption, and side effects were recorded for 24 hours. Results: The time recorded for the first request to analgesia was statistically highly significant shortened, together with significant decrease in intraoperative and postoperative opioid consumption. Significant lower postoperative VAS pain score at rest and with movement for the both the magnesium and the dexamethasone groups were recorded without differences in side effects. Conclusion: Co-administration of magnesium sulphate 50mg or dexamethasone 6mg with epidural bupivacaine and morphine preoperatively as a single shot dose, provides more decrease in intraoperative and postoperative narcotic consumption, and in VAS pain scores at rest or with movement. No significant side effects were recorded.