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Abstract
Management of acute postoperative pain should be of great interest for all hospital institutions. This study compared the effect of adding magnesium sulphate to epidural bupivacaine compared to the addition of fentanyl in patients undergoing lower limb orthopedic surgery under combined spinal epidural anesthesia with respect to onset of postoperative pain, duration of analgesia, total morphine requirements, hemodynamic stability and side effects if any. Methods: 60 patients, ASA I/II were enrolled into the study. All patients had a combined spinal- epidural anaesthesia and after surgery completed, ninety minutes after spinal anesthesia, patients wererandomized by closed envelop technique into one of two groups, group F: (n=30) patients received an initial bolus of epidural 10 ml of bupivacaine 0.25% plus fentanyl 50micg as a bolus dose initially aiming to achieve T10 sensory level, group M: (n=30) patients received an initial bolus of epidural 10 ml of bupivacaine 0.25% plus 0.5ml of magnesium sulphate 10% (50mg) as a bolus dose initially aiming to achieve T10 sensory level followed by monitoring for 12 hours for pain and hemodynamics and side effects, patients received booster dose if they had pain score of 4 or more on VAS