Syed Aftab Haider, Atqua Sultan, Zaira Salman, Salman Waris.
Tranversus Abdominal Plane Block; Efficacy of Magnesium Sulphate as an Adjuvant To Bupivacaine in Transversus Abdominal Plane Block in Abdominal Hysterectomy patients.
Professional Med J Jan ;25(7):1073-7.

Objectives: To determine the efficacy of co-administration of magnesium sulphate (MgSO4 ) with bupivacaine in enhancing the analgesic efficacy of Transversus abdominus plane block (TAP block) in patients undergoing total abdominal hysterectomy. Study Design: Randomized clinical single blinded trial. Setting: Department of Anesthesia, Nishtar Medical University/Hospital Multan. Period: 07 months from March 2017 to October 2018. Methods: We included female patients who presented with uterine or ovarian cancer and planned for total abdominal hysterectomy. In group B patients (n=30) TAP block was given using 0.25% bupivacaine (20 ml). In group M patients (n=30), 19.4 ml 0.25% bupivacaine plus 0.60 ml Mg sulphate. Mean arterial blood pressure, heart rate, VAS pain score and time of 1st rescue analgesia and total dose of rescue analgesia was noted in all patients. For data analysis we used independent sample t-test (Mann-Whitney U test for skewed data) to compare quantitative variables. Chi-square test we used for comparison of ASA status. P-value < 0.05 was taken as significant difference. Results: Mean VAS pain score after 1 hour was 3.27+1.70 in group B and 2.23+1.35 in group M (p-value 0.012), after 2 hours mean VAS pain score was 4.03+2.10 in group B and 2.47+1.25 in group M (p-value 0.001), after 6 hours mean VAS score was 4.53+2.62 in group B and 3.27+1.36 in group M (p-value 0.02). Mean VAS pain score after 12 and 24 hour of shifting the patient in recovery room was no significantly different between the groups (p-value 0.55 & 0.08 resp.). Mean time of 1st rescue analgesia was 7.53+4.92 hours in group B versus 13.96+2.25 hours in group M. Conclusion: Administration of 200 mg of MGSO4 with bupivacaine for TAP block significantly improves the duration of analgesia and reduces the requirement of rescue analgesics in patients undergoing total abdominal hysterectomy.

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