الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Nowadays, regional anaesthesia techniques, particularly peripheral nerve blocking (PNB), are gaining popularity among those who practise anaesthesia. PNB can lessen the need for anaesthetics and analgesics during surgery, as well as for opioid analgesics in the recovery phase. Early postoperative pain relief from the residual sensory block caused by regional anaesthesia can speed up recovery and enable quicker ambulation and discharge.
The identification of the nerve, the insertion of the needle, and the deposition of the local anaesthetic solution at the proper location by a single injection of local anaesthetics are all crucial for the efficacy of a brachial plexus block.
The practise of ultrasound-guided regional anaesthesia is growing in acceptance nowadays. Because ultrasound gives anesthesiologists real-time views, they can more accurately identify anatomical structures, place needles safely, and disseminate local anaesthetic solution across the affected area with less risk of damaging nearby structures. Additionally, it reduces the volume of local anaesthetics, which lessens the likelihood of systemic toxicity.
A medicine that prolongs the duration of analgesia with fewer adverse effects is currently being sought after as adequate adjuvants to the regional nerve block. With varying degrees of success, medications like fentanyl, ketamine, clonidine, dexamethasone, and dexmedetomidine have been used with local anaesthetics for this purpose.
The aim of the work was to compare the effect of magnesium sulphate as an additive to bupivacaine versus sodium bicarbonate as an additive to bupivacaine in ultrasound guided supraclavicular brachial plexus block on patients scheduled for upper limb surgeries. The patients had been evaluated as regards onset and duration of sensory and motor block, duration of analgesia and possible complications.
The present study was carried out in Alexandria Main University Hospital on 70 adult patients of both sexes, Patients were selected having ASA I and II physical status undergoing surgeries of the hand and forearm under ultrasound guided supraclavicular brachial plexus block. Patients were randomly categorized into two equal groups (thirty-five patients each) using the sealed envelope technique.
- group bupivacaine-magnesium (BM): received 18ml of 0.5% bupivacaine and 2ml of 10% magnesium sulphate (200mg).
- group bupivacaine-sodium bicarbonate (BS): received 18ml of 0.5% bupivacaine and 2ml sodium bicarbonate (168mg).
Exclusion criteria:
1. Contraindications to peripheral nerve blocks.
- Patient refusal.
- Bleeding disorders.
- Infection at the puncture site.
- Known allergy to local anaesthetics