الفهرس 
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Abstract
Objective: The aim of this study is to evaluate the effect of adding magnesium sulfate with different doses to bupivacaine on the quality of postoperative analgesia. Material and method: One hundred and twenty patients with age ranging from (25-60) years of either sex undergoing upper limb surgeries at Mansoura University Hospital were randomly allocated into three equal groups : group (B)received 30 ml 0.5 % bupivacaine + 10 ml saline . group (BM500) received 0.5% 30 ml bupivacaine + 500 mg magnesium sulfate (5ml) +5ml saline. Group(BM750) received 0.5 % 30 ml bupivacaine + 750 mg magnesium sulfate (7.5ml) 2.5 ml saline. On coming to the pre-operative room ofregional block, we applied standard monitoring for all patients and administered 0.02 mg / kg midazolam IV prior to the procedure . During the procedure , the patients were supine with their head turned to the other side . We used the US to identify the brachial plexus. Block success was confirmed by loss of sensation to pinprick in all upper limb sensory dermatomes measured every minute till 30 min after finishing theinjection of local anesthetic. Visual analogue score was measured at 2 , 4 , 6 , 12 , 24 hrs postoperatively. Pain was managed if VAS was ≥ 4 or the patient requested analgesia by injection of Ketolac 30 mg . Hemodynamic parameters including heart rate (HR)and mean blood pressure (Mean bl/p)were recorded. Result: This study results proved that adding of magnesium sulfate in either doses of 500 mg or 750 mg to bupivacaine for ultrasound guided supraclavicular nerve block made the analgesic duration longer ( 10.7± 1.1 hrs and 10.8 ± 0.7hrs, respectively) and decreased the postoperative pain and analgesic request after upper limb surgery. Conclusion: The duration of analgesia was no more prolonged with a dose of 750 mg than the dose of 500 mg of magnesium sulfate and there were no superior effects of the dose of 750 mg than the dose of 500 mg.