A COMPARATIVE STUDY BETWEEN PREEMPTIVE MAGNESIUM SULPHATE AND GABAPENTIN IN THE MANAGEMENT OF POSTOPERATIVE PAIN IN ADULTS.

Anup Kumar  Harichandan; Manaswini  Khuntia; Bimal Prasad  Sahu; Chittranjan  Pradhan; Harikrishna  Dalai; Debadas  Biswal; Shibanee  Jena

doi:10.51168/sjhrafrica.v5i3.1025

Authors

Dr. Anup Kumar Harichandan Asst. Professor Anesthesiology, MKCG MCH Berhampur, Odisha.
Dr. Manaswini Khuntia Asst. Professor Obst & Gynecology, MKCG MCH Berhampur, Odisha
Dr. Bimal Prasad Sahu Associate Professor Anesthesiology, MKCG MCH Berhampur, Odisha
Dr. Chittranjan Pradhan Senior Resident Anesthesiology, MKCG MCH Berhampur, Odisha
Prof. Harikrishna Dalai Professor Anesthesiology & Superintendent, SRM MCH Kalahandi, Odisha
Dr. Debadas Biswal Associate Professor Anesthesiology, SLN MCH Koraput, Odisha
Dr. Shibanee Jena Associate Professor Anatomy, JK MCH Jajpur, Odisha

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1025

Keywords:

Pre-emptive analgesia, Magnesium sulphate, Gabapentine, Post-operative analgesia

Abstract

Introduction:

Control of perioperative pain is an important aspect of anesthesia. Though several methods have been tried, pre-emptive analgesia is a debatable concept. Magnesium, an NMDA antagonist, and gabapentin, an alpha2 delta subunit of the calcium channel blocker were used as adjuvants to control perioperative pain. The objective of the present study was to compare the postoperative analgesic effect of Oral Gabapentin 10mg/kg with IV Magnesium Sulphate 50mg/kg in patients undergoing surgery under Regional Anaesthesia.

Materials and methods:

Sixty patients were divided into two groups where group A received 10mg/kg of gabapentin and group B received 50mg/kg of magnesium sulphate before spinal anesthesia. Intraoperative HR, NIBP, ECG, SPO2, urine output, and deep tendon reflexes were monitored. The sedation status of patients was assessed by the Ramsay Sedation Score. The degree of pain in the Postoperative period was assessed by VAS score at intervals of 4hrs up to the first 24hrs and with a VAS score of more than 3, Inj Diclofenac 75mg was given intramuscularly as the rescue analgesic.

Observation:

The patients in the gabapentin group achieved sensory and motor block in 6.2 and 6.3 minutes respectively while patients in the magnesium sulphate group took longer time for the same i.e. 8.1 and 8.4 minutes respectively which was statistically significant (p-value < 0.001). The pain score was significantly lower in the gabapentin group compared to the magnesium group (p-value < 0.05). The requirement for rescue analgesia was higher in the magnesium sulfate group but was not statistically significant.

Conclusion:

Pain score was significantly lower among the patients in the gabapentin group compared to the magnesium sulfate group at different time intervals. Hypotension was observed in a few patients in the magnesium sulfate group.

Recommendation:

Magnesium sulfate as pre-emptive analgesia should be considered to reduce the postoperative requirement of analgesics.