BACKGROUND Post caesarean section pain requires effective analgesia. Effective analgesia is integral to improvement of quality and patient care among lower segment caesarean section (LSCS) patients. Magnesium, an N-methyl-D-aspartate receptor antagonist along with calcium-channel blocker, has previously been investigated for its analgesic properties. But there is scanty previous literature available for intramuscular magnesium sulphate in the analgesic role in post caesarean mothers. The purpose of this study was to evaluate the effect of existing MgSO4 regimens (among severe pregnancy induced hypertension patients, excluding eclampsia) during early 1st 24 hours’ postoperative analgesic requirements in caesarean section patients comparing to only analgesic group. METHODS It is a retrospective observational study, conducted from January 2019 to June 2020. Patients were randomly selected, normal patients as control = 50 who got post-operative inj. diclofenac 75 mg IM twice a day and rescue analgesia inj. diclofenac 75 mg IM. Test sample comprised of 50 randomly selected severe pregnancy induced hypertension (PIH) patients who got prophylactic inj. magnesium sulphate by Pritchard regimen for 24 hrs. post delivery with 4 gm 20 % inj. magnesium sulphate intravenous with 10 gm 50 % intramuscular in both buttocks as loading dose followed by 5 gm 50 % inj. magnesium sulphate intramuscular 4th hourly for 24 hrs. along with inj. diclofenac 75 mg IM twice a day. Visual analogue scale for pain was noted among both the groups, and were compared for the effect of analgesics in the study groups. RESULTS There was a decrease in analgesic consumption and immediate post-operative pain in the group receiving MgSO4 with analgesic (inj. diclofenac 75 mg), in comparison to control group of inj. diclofenac 75 mg. (P < 0.0001). CONCLUSIONS There was a decrease in analgesic consumption in the group receiving MgSO4 plus analgesic, in comparison to control group (analgesic group). Pain severity assessment 2, 6, 12 and 24 hours post operatively showed that there was a statistically significant decrease in pain scores between the study and the control groups (P < 0.0001). It established the role of magnesium sulphate as an adjuvant analgesic along with diclofenac or other traditionally used pain medications among the post caesarean mothers in early post-operative period. KEYWORDS Analgesia, Pregnancy, Post-Operative Analgesia, Magnesium Sulphate, Lower Segment Caesarean Section (LSCS), Pain Relief, Obstetrics
A comparative study using different doses of magnesium sulphate as adjuvant to intrathecal hyperbaric bupivacaine during anaesthesia for lower segment caesarean section
