الفهرس 
PreeclampsiaOnly 14 pages are availabe for public view
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Abstract
P
re-eclampsia is defined as a disorder that occurs in pregnancy after twenty weeks of gestation which manifests as hypertension and proteinuria with at least one maternal organ dysfunction involvement with an incidence of 5-10% of all pregnancies.
The use of spinal anesthesia in pre-eclamptic pregnant woman is of considerable benefit, as these patients present particular hazards with general anaesthesia, such as concerns for rapid airway control and cerebral blood flow alterations during induction of general anaesthesia and intubation.
The incidence of hypotension is high during spinal anesthesia for cesarean section and it may approach values up to 95%. However, the preeclamptic parturients experience less frequent and less severe hypotension and require smaller doses of vasopressors than normotensive parturients after initiation of spinal anesthesia.
Magnesium ion is a natural calcium an¬tagonist, it inhibits calcium entry into the cells via noncompetitive blockade of the dorsal horn N-methyl-D-aspartate (NMDA) receptor, which modulates or prevents central pain sensi-tization.
So the addition of magnesium to bupivacaine for spinal anesthesia significantly improves the duration of postoperative analgesia and reduces the postoperative analgesic consumption in patients with preeclampsia undergoing caesarean section.
The current study examined the hemodynamic effects of adding two different doses of magnesium sulphate (50mg & 100mg) to bupivacaine in patients with severe preeclampsia undergoing caesarean section using spinal anesthesia.
Patients were randomly assigned to one of two Groups;
group A received a premixed solution of 0.5% hyperbaric bupivacaine 1.8 mL and 10% magnesium sulphate 1mL (100 mg) (total volume =2.8 mL).
group B received a premixed solution of 0.5% hyperbaric bupivacaine 1.8 mL, 10% magnesium sulphate 0.5 mL (50mg) and normal saline 0.5 mL (total volume=2.8 mL).
Heart rate, systolic and diastolic pressure was monitored.
Also sensory & motor block, nausea & vomiting, shivering, sedation, APGAR score, postoperative pain were monitored.
The study showed that the addition of different doses of magnesium sulfate (50 & 100 mg) to bupivacaine had no significant hemodynamic effect (systolic blood pressure, diastolic blood pressure and heart rate) on severe preeclamptic patients undergoing caesarean section.
But the addition of 100 mg magnesium sulfate led to a significant delay in the onset of both sensory and motor blockade, and prolonged the duration of sensory and motor blockade compared to 50mg magnesium sulphate.
Also there is no significant difference between the addition of 50 &100mg on the incidence of shivering, nausea and vomiting, sedation, postoperative pain score (at 2,4 and 8 hours) and APGAR score (at 1 and 5 min).