الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
This study had been conducted out in El-Minia University Hospital after approval from the hospital ethical committee in the period from (June 2018 to February 2019). All patients were informed about the procedure & its possible consequence and written informed consents were obtained. The type of the study was randomized, controlled, prospective and double blinded. A total of 120 patients, ASA grade I-II, aged between 18 and 64 were scheduled for lower abdominal surgery.
This study was conducted to evaluate the effect of three different doses of epidural magnesium sulfate on early postoperative pain in patients undergoing lower abdominal surgeries .
Anesthetic technique was standerized in all groups . patients were randomly allocated into four groups each contained 30 patients.
Control group (14 ml bupivacaine + 1 ml saline) , 50 mg group (14 ml bupivacaine + 50 mg MgSO4 in 1 ml saline) , 75 mg group (14 ml bupivacaine + 75 mg MgSO4 in 1 ml saline) or 100 mg group (14 ml bupivacaine + 100 mg MgSO4 in 1 ml saline)
The following variables were observed :
Hemodynamics (HR, MAP, SBP and DBP) were recorded just before the epidural induction as a baseline value, immediately after the block 10, 15, 20, 25, 30,45, 60, 75, 90, 105 and120 minutes during the surgery.
Onset time of sensory block, Onset time of motor block, Duration of sensory block, and Duration of motor block were assessed in minutes.
Number of top up doses needed was recorded.
Pain assessment using a scoring system based on the (VAS) scale consisting of (best to worst: 0 – 10 cm). VAS is measured at the following time immediate postoperative, after 6 hs and after 24 hs postoperatively.
Side effects including hypotension, bradycardia, nausea and vomiting , back pain on injection, headache , hallucination and shivering were noted with no significant difference between groups. No patient in any group developed itching and drowsiness.
The results of this study found that basic charachteristics (age, sex, duration of operation and ASA score) was statistically insignificant between the four groups of patients.
Hemodynamics HR was statistically insignificant between the four groups at all-time intervals .
As regared BP there was statistically insignificant difference between the four groups at all-time intervals except at period between 20&25 min .
As regard onset and duration of block(sensory &motor) in magnesium sulfate groups there was earlier onset and prolonged duration than control group with the best effect occurred with 100 mg group .
As regard to number of top up doses in magnesium sulfate groups was clinically and significantly lesser than control group.
For Visual Analogue Scale (VAS), while comparing the four groups, the differences were statistically insignificant immediate postoperative . But there were statistically highly significant differences between the four groups in VAS at 6 and 24 hours postoperatively with better score with 100 mg group.
As regard to complications ,there were statistically insignificant between the four groups.
Conclusion:
from our results, we concluded that adding magnesium sulfate to epidural local anesthetic resulted in significant prolongation of postoperative analgesia duration, reduction of number of analgesic doses required postoperative, early initiation of both sensory and motor block and prolongation of duration of that block . No side effects were detected. Hemodynamics like SBP,DBP ,MAP and HR showed more stability in MgSO4 groups.
By comparing effect of different doses, we found that results are nearly similar while using doses of (50 mg & 75 mg ). Otherwise , using a dose of 100 mg resulted on more rapid onset , prolonged duration of block , prolonged period of postoperative analgesia and delayed the period before the first analgesic request with more hemodynamics stability with no significant difference on the reported adverse effects.