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Abstract
Intravenous regional anaesthesia (IVRA) is a simple, reliable and cost-effective anaesthetic technique for short surgical procedures involving the hands or feet. The major disadvantages of this technique are the occurrence of tourniquet pain, potential for local anaesthetic toxicity, and minimal residual postoperative analgesia. Several drugs have been added to local anaesthetic for reducing the tourniquet pain and to provide a satisfactory post-operative analgesia. Magnesium (Mg) is the fourth most plentiful cation in the body and the second most plentiful intracellular cation after potassium .Magnesium is necessary for the presynaptic release of acetylcholine from nerve endings and may produce effects similar to calcium-entry-blocking drugs. Magnesium ions are involved as a cofactor in about 300 known enzymatic reactions in the body magnesium blocks the N-methyl-D-aspartate receptor (NMDA) and its associated ion channels, it can prevent central sensitization caused by peripheral nociceptive stimulation. The use of Mg as an adjuvant in the context of perioperative analgesia is novel. This application is based on the antagonist properties of Mg for the NMDA receptor and its inhibitory properties for calcium channels. Calcium channel blockers have shown antinociceptive effects in animals and morphine potentiation in patients with chronic pain. Usage of MgSO4 as a supplement during remifentanil or propofol and anaesthesia has reduced amounts of anaesthetic drugs needed.Lidocaine hydrochloride is a local anaesthetic drug acting by stabilization of the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anaesthetic action. Adverse effects following the administration of lidocaine are dose related with cardiac, neurologic, vascular, or allergic manifestations.