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Year : 2018  |  Volume : 46  |  Issue : 4  |  Page : 275-280

A comparative study between epidural fentanyl, magnesium sulfate, or both for postoperative analgesia in hip surgeries

Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Hend A Ghoneem
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Garahem St., Kafr El-Zayat, El-Gharbia, Tanta
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DOI: 10.4103/tmj.tmj_32_17

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Background Postoperative analgesia after hip surgeries is important for adequate recovery and early mobilization. Epidural analgesia is one of the most accepted techniques. Aim The aim was to evaluate the analgesic efficacy of single bolus administration of epidural fentanyl, magnesium sulfate, and a combination of both in patients undergoing hip surgeries under spinal anesthesia. Patients and methods Ninety patients, 20–65 years, American Society of Anesthesiology I–III, undergoing elective hip surgery under spinal anesthesia were investigated. After wearing off of spinal anesthesia, the patients were allocated into three groups to receive single bolus epidural injection of fentanyl 1 µg/kg in the fentanyl (F) group, magnesium sulfate 75 mg in the magnesium sulfate (M) group, and a combination of both in the fentanyl magnesium sulfate (FM) group. All were diluted to a total volume of 10 ml. Visual analog scale, duration of analgesia, and total consumption of rescue analgesia were recorded. Results A combination of epidural fentanyl (1 µg/kg) and magnesium sulfate (75 mg) produced a significant reduction of postoperative visual analog scale at 3 and 6 h with a longer duration of analgesia and a lower rescue analgesic consumption without increased side effects. Conclusion Epidural fentanyl and magnesium sulfate provides adequate postoperative analgesia but with short duration. However, addition of magnesium sulfate as an adjuvant to epidural fentanyl improves the quality of postoperative analgesia, reduces the demand for rescue analgesia, and prolongs the duration of analgesia without additional side effects.

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