A Comparison of the Analgesic Effect between Magnesium Sulphate and Fentanyl as Adjuvants to Epidural Levobupivacaine in Patients Undergoing Open Reduction and Internal Fixation of Pott's Fracture

Abstract

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.