title: Effect of magnesium infusion on thoracic epidural analgesia.
abstract: BACKGROUND
  Patients of lung volume reduction surgery (LVRS) having an ASA status III or more are likely to be further downgraded by surgery to critical levels of pulmonary function.
  
  
  OBJECTIVE
  To compare the efficacy of thoracic epidural block with (0.125%) bupivacaine, fentanyl combination and (0.125%) bupivacaine, fentanyl combination with adjunctive intravenous magnesium infusion for the relief of postoperative pain in patients undergoing LVRS.
  
  
  METHODS
  Patients were operated under general anesthesia. Thirty minutes before the anticipated completion of skin closure in both groups, (Group A and Group B) 7 ml of (0.125%) bupivacaine calculated as 1.5 ml/thoracic segment space for achieving analgesia in dermatomes of T4, T5, T6, T7, and T8 segments, along with fentanyl 50 μg (0.5 ml), was administered through the catheter, activating the epidural block, and the time was noted. Thereafter, in patients of Group A, magnesium sulfate injection 30 mg/kg i.v. bolus was followed by infusion of magnesium sulfate at 10 mg/kg/hr and continued up to 24 hours. Group B was treated as control.
  
  
  RESULTS
  A significant increase in the mean and maximum duration of analgesia in Group A in comparison with Group B (P<0.05) was observed. Total epidural dose of fentanyl and bupivacaine required in Group A was significantly lower in comparison with Group B in 24 hours.
  
  
  CONCLUSIONS
  Requirement of total doses of local anesthetics along with opioids could be minimized by magnesium infusion; therefore, the further downgradation of patients of LVRS may be prevented.
  
  
  CONCLUSIONS
  Intravenous magnesium can prolong opioid-induced analgesia while minimizing nausea, pruritus, and somnolence.
authors.affiliation: Department of Anaesthesiology & Chest Medicine, Institute of Postgraduate Medical Education and Research /SSKM Hospital, Bose Road, Kolkata, India.
authors.forename: Sampa Dutta
authors.initials: SD
authors.lastname: Gupta
authors.forename: Koel
authors.initials: K
authors.lastname: Mitra
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Mukherjee
authors.forename: Suddhadeb
authors.initials: S
authors.lastname: Roy
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Sarkar
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Kundu
authors.forename: Anupam
authors.initials: A
authors.lastname: Goswami
authors.forename: Uday Narayan
authors.initials: UN
authors.lastname: Sarkar
authors.forename: Prakash
authors.initials: P
authors.lastname: Sanki
authors.forename: Ritabrata
authors.initials: R
authors.lastname: Mitra