Effect of Magnesium Sulfate or Dexamethasone on Postoperative Analgesia in Ultrasound-Guided Quadratus Lumborum Block in Pediatric Lower Abdominal Surgery

Edris, Mohammed Taher; Sabra, Mustafa Mohamed; Daboon, Abdelfattah Mohamed

doi:10.21608/svuijm.2025.340832.2038

Effect of Magnesium Sulfate or Dexamethasone on Postoperative Analgesia in Ultrasound-Guided Quadratus Lumborum Block in Pediatric Lower Abdominal Surgery

Document Type : Original research articles

Authors

Department of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

10.21608/svuijm.2025.340832.2038

Abstract

Background: Magnesium sulfate (MgSO₄) is thought to provide analgesic effects by modulating pain pathways, while dexamethasone may reduce inflammation and prolong nerve block duration. By evaluating their combined effects with QLB, the study seeks to optimize pain management in children post-surgery, ensuring better comfort and reducing the need for opioid analgesics.
Objectives: To look at the impact of adding MgSO₄ or dexamethasone to bupivacaine in ultrasound (US) guided quadratus lumborum block (QLB) on pain management.
Patients and methods: This prospective, randomized, controlled, double blind trial was done on 90 children aged from 6 to 12 years of age, both genders, who underwent lower stomach medical surgery. Patients were split into three equal groups (all received US-directed QLB utilizing bupivacaine after fulfillment of medical procedure) in addition to MgSO₄ in group M, dexamethasone in group D and saline in group C.
Results: Time of first rescue analgesia and total paracetamol consumption were significantly lower in group D than group M and lower in group M and gathering D than group C (P<0.05). Facial pain score was substantially unique at 4h, 8h, 12h and 16h among three groups (P <0.05). Total pethidine consumption was lower in group M and group D than in group C (P <0.001).
Conclusions: In pediatrics going through lower stomach medical procedures, dexamethasone, and MgSO₄ were viable as adjuvant to bupivacaine in QLB in bringing down facial pain score and opioids utilization and deferring time to protect with better hemodynamics stability.

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