The Analgesic Effects of Bupivacaine and Magnesium Sulfate Combination, Bupivacaine, and Adrenaline Combination and Bupivacaine Alone on Post-cesarean Section Pain: A Randomized Clinical Trial

The present study was performed to compare the analgesic effects of bupivacaine and magnesium sulfate combination on post-cesarean (C) section pain.

The present single-blind randomized clinical trial was conducted on 160 C-section candidates. The participants were randomly divided into four groups. When the fascia healed, the first group received 20 mL of 0.25% bupivacaine and the second group received 20 mL of 0.25% bupivacaine combined with subcutaneous adrenaline. In addition, both groups received 50 mL of intravenous normal saline. Further, the third group received subcutaneous bupivacaine and 50 mg/kg of magnesium sulfate and the fourth group received subcutaneous and intravenous normal saline as a placebo. The pain intensity was assessed 2, 6, 12, 18, and 24 hours after spinal anesthesia using the visual analogue scale (VAS) for pain. The dose of pethidine (as a standard analgesic) and hemodynamic parameters (i.e., heart rate [HR] and blood pressure [BP]) was recorded as well. The obtained data were then analyzed utilizing ANOVA, Tukey’s HSD, and repeated measures ANOVA tests.

The intensity of pain and the dose of pethidine decreased significantly in the combination of bupivacaine with magnesium compared to the other groups at all times (P < 0.001). However, diastolic BP significantly increased in the bupivacaine + adrenaline group in comparison with the other groups (P = 0.02).

Overall, bupivacaine combination with magnesium sulfate is suitable for controlling post-cesarean section pain.