MAGNESIUM SULPHATE VS CLONIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN EPIDURAL ANAESTHESIA FOR PATIENTS UNDERGOING LOWER LIMB SURGERIES: A COMPARATIVE STUDY

Abstract

Epidural anesthesia is a safe and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief. To address the problems of limited duration of action and to improve the quality of analgesia intra-operatively and postoperatively, various adjuvants have been added to bupivacaine. The present study is designed to evaluate the effect of magnesium sulphate vs clonidine as an adjunct to 0.5% Bupivacaine in epidural anesthesia for patients undergoing lower limb surgeries in terms of onset, duration and degree of sensory and motor block, sedation and pain. 90 patients of age group 18-60 years of ASA grade I & II of either sex undergoing lower limb surgeries were included in this prospective study who were randomly allocated into three groups. Group A received bupivacaine 0.5%(19ml) +normal saline 0.9% (1.0ml), Group B received bupivacaine 0.5%(19ml)+ magnesium sulphate 50mg dissolved in 0.9% normal saline (1.0ml) and Group C received bupivacaine 0.5%(19ml) + clonidine 150 mu gm(1.0ml). Assessments of sensory block were performed at 5, 10, 15, 20, 25, 30 min and then every 10 min until the return of normal sensation.). Assessment of motor block were performed immediately after the assessment of sensory block until the return of normal motor function. The onset and end of all degrees of motor blocks were assessed bilaterally according to the Modified Bromage scale. Duration of analgesia, patient's satisfaction, duration of motor block and adverse effects were assessed and recorded. We concluded that co-administration of epidural magnesium sulphate 50MG with bupivacaine 0.5% produces predictable rapid onset of surgical anesthesia without any side-effects, and addition of clonidine 150 mu gmto epidural bupivacaine 0.5% produces prolonged duration of anesthesia with sedation. The results of our study suggest that magnesium may be a useful alternative as an adjuvant to epidural bupivacaine as clonidine.