Evaluation of Adding Magnesium Sulfate to (Fentanyl/Bupivacaine)Bi-mixture as an Adjuvant to Local Anesthesia in Caudal Block Among Pediatrics in Lower Abdominal Urological Surgeries. a Prospective Randomized Comparative Study

A total of 50 pediatric patients undergoing lower abdominal urological surgeries will be enrolled in this prospective randomized controlled (RCT) study.

I- Randomization:

All included subjects will be randomly allocated and will be divided into two groups; (Group A): will receive [Fentanyl / Bupivacaine], and (Group B): will receive magnesium sulfate added to the previous bi-mixture [Fentanyl / Bupivacaine]. Using computer generated number and concealed using sequentially numbered, sealed opaque envelope technique. There will be no restrictions or stratification in the randomization process. The allocation envelope will be opened by the assistant lecturer at the time of anesthetic preparation. Also, the drug preparation will be conducted by an anesthetist who will not involve in any of the study collection data. Finally, the data will be analyzed on an intention-to-treat basis and included all patients who were randomly assigned.

II- Study protocol

1. Pre-operative preparation All children will be anaesthetized in accordance with the local policy of the Abou El-Resh pediatric hospital-Cairo University's pediatric anesthetic unit. Except for oral clear fluid intake 2 hours before surgery, all children will fast for 6 hours. Patients will attend in the preparation room one hour before the operation to get a preoperative checkup, their age and body weight will be recorded as well.
2. Intra-operative management