title: Magnesium sulphate as an adjuvant to bupivacaine in ultrasound-guided transversus abdominis plane block in patients scheduled for total abdominal hysterectomy under subarachnoid block.
abstract: OBJECTIVE
  Transversus abdominis plane (TAP) block has proven to be an effective component of multimodal analgesic regimens for a variety of abdominal procedures. Magnesium sulphate (MgSO4) N-methyl-D-aspartate receptor antagonist has the potential to be an ideal adjuvant in TAP block. We studied the efficacy of MgSO4 as an adjuvant to bupivacaine in TAP block in patients scheduled for total abdominal hysterectomy (TAH) under subarachnoid block (SAB).
  
  
  METHODS
  Sixty-five women belonging to American Society of Anesthesiologists physical status 1 or 2, aged between 35 and 70 years, scheduled for TAH under SAB were recruited. Patients in Group B (n = 32) received 18 mL 0.25% bupivacaine (45 mg) with 2 mL normal saline (NS), whereas those in Group BM (n = 33) received 18 mL 0.25% bupivacaine (45 mg) with 1.5 mL (150 mg) MgSO4 and 0.5 mL NS in the ultrasound (USG)-guided TAP block performed on each side after the completion of the surgery under SAB. They were evaluated for pain at 0, 2, 4, 6, 12 and 24 h, time to first rescue analgesic and duration of postoperative analgesia were noted.
  
  
  RESULTS
  The post-operative visual analogue scale (VAS) scores were lower in Group BM at 4, 6 and 12 h (P < 0.05). Mean duration of analgesia was significantly prolonged in Group BM with lesser requirement of rescue analgesic (P < 0.05) up to 12 h.
  
  
  CONCLUSIONS
  MgSO4 (150 mg) as an adjuvant to bupivacaine in USG-guided TAP block reduces post-operative pain scores, prolongs the duration of analgesia and decreases demands for rescue analgesics.
authors.affiliation: Department of Anaesthesia, DRPGMC, Kangra, Himachal Pradesh, India.
authors.forename: Shelly
authors.initials: S
authors.lastname: Rana
authors.affiliation: Department of Anaesthesia, DRPGMC, Kangra, Himachal Pradesh, India.
authors.forename: Ravinder Kumar
authors.initials: RK
authors.lastname: Verma
authors.affiliation: Department of Anaesthesia, DRPGMC, Kangra, Himachal Pradesh, India.
authors.forename: Jai
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Anaesthesia, DRPGMC, Kangra, Himachal Pradesh, India.
authors.forename: Sudarshan Kumar
authors.initials: SK
authors.lastname: Chaudhary
authors.affiliation: Department of Anaesthesia, DRPGMC, Kangra, Himachal Pradesh, India.
authors.forename: Ankita
authors.initials: A
authors.lastname: Chandel
keywords: Adjuvants; anaesthesia; analgesia; magnesium sulphate; pain; postoperative.