Magnesium sulfate versus dexamethasone as an adjuvant in the ilioinguinal and iliohypogastric nerve blocks

B. Refaie, Islam Ahmed, A. Hassan, Fouad Soliman, A. Abdelkareem
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Abstract

Introduction Ilioinguinal and iliohypogastric (IIIH) nerve blocks help to manage postoperative pain that occurs following inguinal hernia repair or varicocelectomy. Aim The study aimed to compare the effect of adding magnesium sulfate or dexamethasone to levobupivacaine for iliohypogastric and ilioinguinal nerve blocks, in terms of postoperative analgesic length, visual analog scale ratings, first analgesic requirements, and hemodynamic changes. Patients and methods The study included 86 patients, aged 20–70 years, who were divided into two groups (D and M). Patients in group D received 9 ml of 0.5% levobupivacaine for the nerve block plus 1 ml dexamethasone (8 mg), whereas patients in group M received 9 ml 0.5% levobupivacaine plus 1 ml magnesium sulfate 10% (100 mg). Postoperative analgesia, visual analog scale scores, and any complications were documented. Results Group D had a significantly longer analgesic time. A significantly lower amount of analgesic was consumed on the first postoperative day with significantly low pain score as compared with group M. Conclusion The addition of dexamethasone to levobupivacaine for IIIH nerve blocks improved the postoperative analgesia.
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硫酸镁与地塞米松在髂腹股沟和髂腹下神经阻滞中的辅助作用
髂腹股沟和髂胃下神经阻滞有助于控制腹股沟疝修补或精索静脉曲张切除术后发生的术后疼痛。目的比较左旋布比卡因中添加硫酸镁或地塞米松对髂下胃和髂腹股沟神经阻滞的术后镇痛时间、视觉模拟评分、首次镇痛需求和血流动力学变化的影响。患者和方法86例患者,年龄20 ~ 70岁,分为D组和M组,D组给予0.5%左布比卡因用于神经阻滞9ml +地塞米松1ml (8mg), M组给予0.5%左布比卡因9ml + 10%硫酸镁1ml (100mg)。记录术后镇痛、视觉模拟评分和任何并发症。结果D组镇痛时间明显延长。与m组相比,术后第1天镇痛药用量明显减少,疼痛评分明显降低。结论左布比卡因加用地塞米松治疗iih神经阻滞可改善术后镇痛效果。
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