Epidural Fentanyl and Fentanyl Plus Magnesium for Post-Operative Analgesia in Lower Extremity Surgery

Abstract

Background: The present study was conducted to assess the efficacy of epidural fentanyl with a combination of epidural fentanyl and magnesium in lower extremity surgery. Subjects and Methods : This study was conducted on 100 ASA I/II patients scheduled to undergo elective lower limb orthopedic surgeries. Group I patients received epidural fentanyl 50 µg (1cc) diluted and made up to 6cc with normal saline. Group II patients received epidural fentanyl 50 µg (1cc)+ Magnesium sulphate 50mg (4 units in insulin syringe of 50% solution) diluted and made up to 6cc with normal saline. Patient data such as indication for surgery, the anesthetic details, intraoperative monitoring, post-operative follow-up, etc was recorded. Results: Each group had 36 males and 14 females. Time is taken for the highest sensory level in group I was 13.92 4.50 minutes and 12.24 3.43 minutes in groups I and II respectively. The mean duration of surgery was 99.00 13.31 minutes in group I and 92.20 15.21 in group II. Time for Regression to L1 was 118.80 13.41 and 119.60 17.85 minutes in group I and II respectively. The duration of analgesia (min) was 107.00 25.82 and 143.40 39.57 minutes in group I and II respectively. Common adverse events were nausea/ vomiting seen 2 in group I and 4 in group II and urinary retention seen 0 in group I and 2 in group II. The difference was non- significant (P> 0.05). Conclusion: Authors found that the addition of magnesium sulfate to epidural fentanyl for elective lower limb orthopedic surgeries has prolonged the duration of fentanyl analgesia without any significant side effects.