The Effect of Adding Magnesium to Bupivacaine as an Adjuvant in Continuous Pectoralis Nerve II (PECs) Block in Simple Mastectomy Volume 2 - Issue 5

Eman M Kamal Abo Seif, Walid Y Kamel and Amr M Hilal Abdou*

• Department of Anesthesia, Ain Shams University, Egypt

Received: February 10, 2020;  Published: February 20, 2020

Corresponding author: Amr M Hilal Abdou, Department of anesthesia and intensive care. Ain Shams University, Egypt

DOI: 10.32474/GJAPM.2020.02.000148

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Abstract

Background and Aim: Breast surgeries are associated with post-operative pain and restricted shoulder mobility, so the aim of this study is to assess the analgesic efficiency and safety of Continuous Pectorals II (PECs) block by adding magnesium to bupivacaine as an adjuvant versus bupivacaine as a sole agent in cases of simple mastectomy.

Patients and Methods: This randomized double blinded study designed to compare the analgesics efficacy and safety of continuous PECs II using bupivacaine versus continuous PEC II using bupivacaine plus magnesium in patients undergoing simple mastectomy and postoperative period. We enrolled 40 adult females ASA I-II patients’ candidates for simple mastectomy without axillary clearance. All patients were randomly distributed into two groups. Control group: prior to surgical incision patients had ultrasound guided PEC II continuous block with 10ml plain bupivacaine 0.25% plus followed by infusion of 8ml normal saline per hour. Magnesium group: patients were given 10ml plain bupivacaine 0.25% plus 0.5 gm (5ml) magnesium sulfate followed by infusion of 0.25% plain bupivacaine 7ml/h. plus 10 mg (1 ml) magnesium sulfate infusion per hr.

Results: For assessment of the postoperative pain scores by the VAS; our results showed significant reduction in the magnesium group (P<0.001) in comparison with control group. Intraoperative vital data in the form of heart rate (HR) and mean arterial blood pressure (MAP) showed highly significant decrease of the heart rate in the magnesium group (P≤0.001) after 30 minutes from the block till 2 hours after the block compared to the control group, in addition to significant decrease in MAP (P = 0.036) after the block by 30 minutes. Postoperative vitals showed significant decrease of HR (P=0.016) in magnesium group 4 hours after surgery till the following day, highly significant decrease in RR (P <0.001).

Conclusion: This clinical study proven that mixing of magnesium sulphate to bupivacaine during PECs II block provided a solid safe prolonged motor and sensory block, besides the reduction of postoperative additional rescue pain medications and pain scores.

Abstract| Introduction| Methodology| Anesthetic Management| PECs II Block Technique| Collected Data| Statistical Analysis| Results| Discussion| Conclusion| Conflict of interest| Author’s Contribution| References|