COMPARATIVE STUDY TO EVALUATE THE QUALITY OF ANESTHESIA WITH NITROGLYCERINE AND MAGNESIUM SULPHATE AS ADJUVANTS TO LIGNOCAINE IN INTRAVENOUS REGIONAL ANESTHESIA

Abstract Introduction: Intravenous Regional Anesthesia (IVRA) is a concise, stable, and effective treatment with a fast onset of action and speedy recovery after tourniquet release. Although lignocaine is a popular local anesthetic agent, it has the restriction of having a limited duration of anesthesia and being unable to offer postoperative analgesia; hence, other additives were added to it. This randomized control study was conducted to evaluate and compare the quality of anesthesia with Magnesium sulphate and Nitroglycerine as adjuvants to Lignocaine in intravenous regional anesthesia. Materials and methods: This study included upper arm surgery patients, a pneumatic tourniquet was wrapped around the arm to isolate the proximal vascular system. Totally, 60 patients, belonging to ASA 1and 2 grades posted for elective surgery of upper arm were selected and divided randomly into two groups. Patients in LM group received 10ml of 15% Magnesium sulphate with 3mg/kg 2% Lignocaine diluted up to 40ml with saline and LN group received 200mcg of Nitroglycerine with 3mg/kg 2%Lignocaine diluted up to 40ml with saline. Sensory and motor block onset time, tourniquet pain, intraoperative haemodynamics, sensory and motor recovery time and time for first rescue analgesia were noted and evaluated. Results: The onset time for sensory blockade was shorter in Magnesium group compared to Nitroglycerine, however onset for motor blockade was shorter in Nitroglycerine group. The intraoperative VAS score was significantly low in both the groups and no changes in haemodynamic variables observed between two groups. Sensory and motor recovery was prolonged in Magnesium group. The time for rescue analgesia was prolonged in Magnesium group. Conclusion: The addition of Magnesium sulphate to lignocaine in IVRA produce faster onset of anesthesia and prolonged post-operative anesthesia compared to Nitroglycerine with no serious side effects.