Hyaluronidase Versus Magnesium Sulphate as Adjuvants to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

Background: Aim of this trial was to assess the effect of hyaluronidase and MgSo4 when added separately or in combination to bupivacaine on the onset of sensory and motor block, quality of block and effect on duration of action. Method: Eighty ASA I, II patients of either sex undergoing upper limb Surgery under ultrasound‑guided supraclavicular brachial block were recruited in this prospective randomized double blinded controlled study and divided in to four groups each group contain 20 patients. First group received (28 ml 0.5% bupivacaine and 2 ml 0.9% normal saline). Second group received (28 ml 0.5% bupivacaine and 1000 unit hyaluronidase dissolved in 2 ml 0.9% normal saline). Third group received (28 ml 0.5% bupivacaine and 2 ml of MgSo4 containing 200 mg). Fourth group received (28 ml 0.5% bupivacaine and 2 ml of MgSo4 containing 200 mg mixed with 500 unit hyaluronidase). Results: Hyaluronidase fastened the onset but didn’t affect the duration however MgSo4 prolonged the duration of postoperative analgesia without effect on the onset of block.