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Abstract
Background and Aims Administration of magnesium sulphate via different routes has been used in anaesthetic practice for decreasing perioperative pain. It is N-methyl d-aspartate (NMDA) receptor antagonist and suppresses these receptor induced inflammation and hyper responsiveness. The antinociceptive effect of magnesium sulphate is not only useful in chronic pain, but it also determines in part, the duration and intensity of postoperative pain. These effects are due to calcium antagonism and decrease influx of calcium into the cell and antagonism of NMDA receptor. As these receptors regulate neuronal signalling and are involved in pain processing, magnesium sulphate by blocking this receptor, decreases postoperative pain as well.
Aim of the work studying analgesic efficacy of intraperitoneal instillation of a combination of Magnesium sulphate with bupivacaine versus ordinary parentral analgesics for pain relief after laparoscopic surgeries in pediatrics.
Methods Groups: Group1: will receive ordinary analgesics via intravenous route as paracetamol (7.5- 10 mg/kg) and ketorolac (0.5 mg/kg).
Group2: will receive (Magnesium sulphate 40 mg/kg and bupivacaine 4 mg/kg) in 30 ml of isotonic 0.9%N.S intra peritoneal at the end of surgery. Patient evaluated regarding FLACC score.
Results statistically significant difference according to FLACC.
highly statistically significant difference between the groups according to time to first analgesic administration.
and total analgesic requirement in the first 24h postoperative.
Conclusions The intraperitoneal administration of combination of magnesium sulphate and bupivacaine is a safe and effective method in the management of postoperative pain after laparoscopic surgeries more than intravenous administration of ordinary analgesics in laparoscopic surgeries in pediatrics.