Abirbhab Pal1, Dilip Kumar Pal2, Anjan Dasgupta3
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.
