Background The use of opioids in epidural anesthesia has become popular to optimize postoperative analgesia. The present study was designed to compare the analgesic efficiency of epidural infusion of (magnesium sulfate added to levobupivacaine) compared to (fentanyl added to levobupivacaine) and (levobupivacaine) alone. Objective The aim of this study was to assess the post-operative analgesic efficiency of Magnesium Sulphate as an additive to Levobupivacaine in comparison with either Levobupivacaine alone or the combination of Levobupivacaine and Fentanyl. Patients and Methods Ain Shams university hospitals. After obtaining an informed consent; 45 patients admitted for open reduction and internal fixation of Pott's fracture, were blindly randomized into three groups; group N, group M or group F. Group N receive levobupivacaine, group M receive levobupivacaine and magnesium, and group F receive levobupivacaine and fentanyl. Results The study showed that the onset of both sensory and motor blocks was significantly faster in the group receiving magnesium and levobupivacaine in comparison with the other two groups. In addition, heart rate was significantly lower in the 2 groups receiving magnesium and fentanyl as adjuvant to levobupivacaine compared to the third group. Conclusion It was concluded that using magnesium sulphate as an additive to epidural levobupivacaine infusion produces good analgesia without side effects; it proved to fasten the epidural block in comparison to both the levobupivacaine and the levobupivacaine and fentanyl groups, besides it increased the duration of post operative analgesia in comparison with levobupivacaine group.

Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stays and an increased likelihood of chronic pain. Systemic analgesics (opioids and non-opioids) have long been used for postoperative pain, then neuroaxial or peripheral nerve blocks were employed. Local anesthetics alone were used, then various adjuvants were added to achieve quick, dense and prolonged block. Objective The aim of this study was to study the effect of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block. The comparison included the onset and the duration of the sensory and motor blocks, the duration of analgesia of the block as well as their effects on the postoperative analgesic requirements. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done. Patients and Methods In our study, 60 patients were randomly divided into 2 equal groups. Control group received bupivacaine only (0.5%) and dexa group in which 8 mg of dexamethasone were added to bupivacaine. All patients received equal volumes of 20 milliliters. Results Our study showed that addition of 8 milligrams of dexamethasone to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of motor blocks and significantly prolonged motor and sensory block durations. In addition, dexamethasone prolonged the duration of analgesia of the plexus block significantly, as proved by the time of request of analgesia. Moreover, in dexa group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of dexamethasone also did not affect the hemodynamics to a significant level. This makes dexamethasone with bupivacaine more superior than the use of bupivacaine alone. Conclusion Addition of dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset motor blocks. Addition of dexamethasone to bupivacaine significantly prolongs of both sensory and motor block durations.