European Journal of Cardiovascular Medicine

BACKGROUND- Brachial plexus blockade provides superior pain control with excellent intraoperative anaesthesia as well as post-operative analgesia in upper limb surgeries, eliminating the need for intra-operative opioids and minimizing the need for post- operative opioids. Local anaesthetics, singularly, for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia. Magnesium Sulphate( MgSO4) has been shown to circumvent the nociceptive effects by blocking the N-Methyl D -Aspartate receptors and associated Ca+ channels, thus preventing the central sensitization caused by peripheral nociceptive stimulation, thus MgSO4 was selected as an adjuvant to local anaesthetics in this study, as it prolongs the duration of analgesia in the post-operative period. This study tends to focus on the advantage of using magnesium sulphate as an adjuvant to bupivacaine on the post operative analgesia as well on the duration of sensory and motor blockade in the patients undergoing upper limb surgeries. MATERIAL AND METHODS  The study was carried out after obtaining Ethical clearance with 90 patients of ASA I -II group scheduled to have arm & forearm surgeries. The patients were randomly divided into two groups. Group BM (n=45) receiving 0.5% Bupivacaine (1.5 mg/kg ) + Magnesium sulphate 2 ml of a 10 % solution diluted to make a net volume of 30ml  and  Group B (n=45) receiving 0.5% Bupivacaine (1.5 mg/kg )+ 2 ml of normal saline, diluted to make a net volume of 30 ml. Sensory & motor block characteristics  were assessed with pinprick & Modified Bromage Scale. Haemodynamic changes & side effects were also  observed & recorded . These were compared with the same stimulation in the contralateral hand. Statistical analysis was performed using Student t test and Chi square test. RESULTS.  In our study, we found that the onset of sensory block was 13.70 ± 2.22 min in Group BM and 19.42 ± 2.49 min in Group B showing highly significant difference (p < 0.01) between the study groups & the mean time for onset of motor block for group BM to be 18.67 ± 2.35 min and 25.37 ± 2.81 for group B showing highly statistical significant difference (p < 0.01) in between the two groups. The mean time duration of motor block for group BM was 332.95 ± 87.85 min and that for group B was 229.08 ± 45.38 min showing statistical significant difference (p < 0.01) in between the two groups. The mean duration of analgesia for group BM was 473.44 ± 88.05 min and that for group B was 278.11 ± 65.10 min. There is a highly statistical significant difference (p < 0.01) in between the two groups. In our study, systolic BP, diastolic BP, MAP, heart rate, SpO2 and respiratory rate were comparable in both the groups and the p value was found to be insignificant. No side effect was noticed in both the groups. CONCLUSION Group BM (0.5 % Bupivacaine + 2 ml of 10 % magnesium sulphate) showed a shorter onset for both sensory and motor blockade with a significantly increased duration of post operative analgesia.