A comparative study of three different doses of magnesium sulphate as adjuvant with injection bupivacaine 0.5 percent heavy for infraumbilical procedures under subarachnoid block

Regional Anesthesia in Lower Limb Surgeries:

Regional anesthesia, especially subarachnoid block (SAB), is preferred for lower limb surgeries over general anesthesia due to various benefits, such as:

Ease of administration

Dense sensory, motor, and sympathetic blockade

Better post-operative pain relief

Reduced incidence of postoperative nausea and vomiting (PONV)

Lower cost compared to general anesthesia

Reduced thromboembolism risk

Bupivacaine in SAB:

Bupivacaine is the most commonly used local anesthetic for SAB.

However, it has a limited duration of action, necessitating the use of adjuvants for prolonged effects.

Role of Adjuvants:

The use of adjuvants in SAB is gaining popularity for enhancing blockade duration, improving patient satisfaction, and achieving better surgical outcomes.

Adjuvants also provide prolonged analgesia, optimal resource utilization, and a higher success rate compared to general anesthesia.

Magnesium Sulfate as an Adjuvant:

Magnesium sulfate is an effective adjuvant for prolonging the duration of SAB.

It is a non-competitive antagonist of N-Methyl D-Aspartate (NMDA) receptors, preventing central sensitization from peripheral nociceptive stimulation.

Its antinociceptive properties contribute to prolonged pain relief, especially for postoperative pain management.

Safety of Magnesium Sulfate:

Magnesium sulfate has minimal adverse effects when used in low doses, making it a safe and beneficial addition to SAB for enhancing patient outcomes and reducing pain.