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Effect of magnesium infusion on thoracic epidural analgesia

Author(s): Gupta Sampa | Mitra Koel | Mukherjee Maitreyee | Roy Suddhadeb | Sarkar Aniruddha | Kundu Sudeshna | Goswami Anupam | Sarkar Uday | Sanki Prakash | Mitra Ritabrata

Journal: Saudi Journal of Anaesthesia
ISSN 1658-354X

Volume: 5;
Issue: 1;
Start page: 55;
Date: 2011;
Original page

Keywords: Bupivacaine | epidural opioid | lung volume reduction surgery | magnesium infusion | post-thoracotomy pain

Introduction: Patients of lung volume reduction surgery (LVRS) having an ASA status III or more are likely to be further downgraded by surgery to critical levels of pulmonary function. Aim: To compare the efficacy of thoracic epidural block with (0.125%) bupivacaine, fentanyl combination and (0.125%) bupivacaine, fentanyl combination with adjunctive intravenous magnesium infusion for the relief of postoperative pain in patients undergoing LVRS. Methods: Patients were operated under general anesthesia. Thirty minutes before the anticipated completion of skin closure in both groups, (Group A and Group B) 7 ml of (0.125%) bupivacaine calculated as 1.5 ml/thoracic segment space for achieving analgesia in dermatomes of T4, T5, T6, T7, and T8 segments, along with fentanyl 50 ΅g (0.5 ml), was administered through the catheter, activating the epidural block, and the time was noted. Thereafter, in patients of Group A, magnesium sulfate injection 30 mg/kg i.v. bolus was followed by infusion of magnesium sulfate at 10 mg/kg/hr and continued up to 24 hours. Group B was treated as control. Results and Analysis: A significant increase in the mean and maximum duration of analgesia in Group A in comparison with Group B (P

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