Objective: The aim of this study is to determine the role of preoperative low\ndose intravenous MgSO4 when given adjuvant to ultrasound guided transversus\nabdominis plane (TAP) block in augmenting postcesarean analgesic effects\nand reducing opioid requirements during the first 24 hours. Subjects and\nMethods: In this prospective, randomized double blind study, a total of sixty\nfull term pregnant women were recruited for the study underwent caesarean\nsection. Thirty patients were assigned to MgSO4 group (A) and another thirty\nto placebo group (B). Participants in group (A) received 50 mg/kg MgSO4 in\n100 ml isotonic saline intravenous (IV) over 20 minutes prior to induction of\ngeneral anesthesia by 30 minutes while participants in group (B) received 100\nml isotonic saline (placebo) by the same route and over the same duration as\ncontrol. Results: Visual Analogue Scale (VAS) was analysed within 24 hours\npostoperatively. The mean pain score at 6 and 12 hours postoperatively was\nsignificantly lower in MgSO4 group compared to control group (40.4 �± 5.12 vs\n53.6 �± 4.92; 26.1 �± 3.01 vs 35.5 �± 3.98 respectively, p = 0.012, 0.005). Comparing\nboth groups regarding the mean time interval of first rescue analgesia\n(morphine sulphate) requested by the patients, it was longer in MgSO4 group\ncompared to control group. The total dose of rescue analgesia consumed during\n24 hours was analysed and it was significantly higher in control group\ncompared to MgSO4 group (10.1 �± 0.95 vs 6.2 �± 0.87, p = 0.001). Conclusion:\nWe concluded that preoperative low doses (50 mg/Kg) of MgSO4 with general\nanesthesia combined with ultrasound guided TAP block offer longer postoperative\npain free periods thus reducing total opioid consumption. In addition\nto the safety of the drug to the mother and fetus so we recommend IV MgSO4\nas an adjuvant therapy with TAP block.
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