A comparative study between magnesium sulfate and dexmedetomidine as adjuvants to bupivacaine using ultrasound-guided lumbar-plexus block in lower abdominal surgeries

Abstract

Background and aim Pain international association of described pain as an unpleasant sensory and emotional practice accompanied with actual or potential tissue injuries. Opioid administrations remain the cornerstone of postoperative pain relief, but it may cause significant side effects, including sedations, nausea, vomiting, and urinary retention. We aimed to compare the efficacy of ultrasound-guided lumbar-plexus block through adding magnesium sulfate and dexmedetomidine (DEX) to bupivacaine on postoperative analgesia and thereafter surgical operation. Patients and methods This prospective, randomized, double-blinded, controlled research was performed on Al-Azhar University Hospitals. A total of 75 cases of both sexes, age between 21 and 65 years, American Society of Anesthesiologists class I– II, were listed for elective lower-abdomen surgical operation underneath general anesthesia. Results Pain scores were decreased significantly in the study groups for 12 and 18 h in BM and BD, respectively, also, there was a significant decrease at 2, 4, 6, 8, and 12 h in the BD group lesser than the BM group postoperatively. The time to the initial analgesic appeal was significantly extended in the BD group (11.9±1 h) than the BM group (10.6±0.7 h). Conclusion Posterior lumbar-plexus block utilizing 22 ml of bupivacaine 0.5% with DEX 1 μg/kg decreases pain score, opioid consumption, prolongs duration of analgesia, better hemodynamics stability, and perfect outcome of cases’ satisfaction postoperatively compared with posterior lumbar-plexus block using 22 ml of bupivacaine 0.5% with magnesium sulfate 150 mg. DEX provides faster onset time and longer periods of MB and extended period of analgesia with smaller consumptions of postoperative rescue analgesia.