Low Dose Magnesium Sulphate

This prospective, randomized controlled clinical trial aims to establish the effect of magnesium sulphate during nasal surgery regarding deliberate hypotension, postoperative analgesia and sedation with minimal side effects.

this study will be conducted in the plastic surgery and ENT operating rooms at ASUH 130 patients undergoing rhinoplasty or functional endoscopic sinus surgery (FESS) operation under general anaesthesia.

patients will be allocated into 2 groups 65 patients each using a computer-generated randomization list.

Group (P): Patients will receive propranolol 1-2 mg. Group (PM): Patients will receive propranolol 1-2 mg in addition to magnesium sulphate infusion 10 mg/kg.

• ABP and HR are continuously monitored and will be recorded before the start of anaesthesia (T1), after intubation (T2), at skin incision (T3), at manipulation of nasal bones (T4), at extubation (T5), before discharge to PACU (T6), and after 30 min in PACU.
• Surgical duration (time from skin incision till skin closure).
• Extubation time (from the end of anaesthesia to extubation)
• Modified Alderete score will be assessed and recorded every 5 minutes until discharge. Patients will be discharged upon achieving an Aldrete score of ≥ 9.
• The time to discharge will be recorded.
• VAS score for pain:
• Analgesic requirements: The time to first demand analgesia and the total amount of analgesia required in the 1st 24 will be recorded.
• Sedation score: the degree of sedation will be assessed using the Ramsy sedation score where all be recorded

Inclusion criteria

• Patients undergoing rhinoplasty or functional endoscopic sinus surgery (FESS) operation under general anesthesia
• ASA I or II
• Duration of surgery will be 1-2 hours

Exclusion criteria

• Hypertension,
• Myasthenia gravis or other muscular disease,
• Impaired kidney or liver functions,
• History of drug or alcohol abuse,
• History of antidepressant and calcium channel blocker use,
• Mental retardation and hysterical patients.