الفهرس 
Physiological considerationsOnly 14 pages are availabe for public view
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Abstract
Although, the postoperative pain is self limiated, it is frequently severe and may be the most unpleasant aspect of the hospital stay. It is a potent trigger for the stress response, activates the autonomic system, and is though to be an indirect cause of adverse effects on various organ system. Numerous clinical studies investigating the effects of intravenously injected MgSO4 on intraoperative anesthetic consumption and postoperative pain perception have shown that MgSO4 reduces the intraoperative and postoperative analgesic requirements. Also, recent studies have described the use of MgSO4 as adjuvant to local anesthetics, which has been little studied in that perspective. However, it has
been used safely both intrathecal and epidural in humans and its safety profile has been documented by histopathological analysis in experimental models. So the current study was designed to assess the effect of adding epidural MgSO4 to bupivacaine in epidural anesthesia and its influence on postoperative analgesia consumption. In this clinical trial, 50 patients undergoing elective lower limb surgery
under epidural anaesthesia were randomly assigned to one of two groups: Group (S): patients received epidural mixture of 20ml plain bupivacaine 0.5% and 2 ml saline. Group (M): patients received epidural mixture of 20ml plain bupivacaine 0.5% and 50 mg magnesium sulfate in 2 ml saline. Intraoperative: top up doses of 2ml/segment after two segment regression ,i.e
4ml of plain bupivacaine 0.25%. patients in both groups will receive epidural bolus doses of ٢٥ μg fentanyl (5ml) on demand. All patients in the two groups were assessed and monitored for hemodynamics (heart rate, oxygen saturation, mean arterial blood pressure, and respiratory rate).sensory block level and duration. motor block in lower limb as assessed by the modified bromage scale. pain and analgesia were assessed by 100-mm visual analog scale (VAS) Duration of analgesia and fentanyl administerated/24 hours. Sedation score. Adverse events (respiratory depression, urinary retention, nausea).