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magnesium sulfate + bupivacaine is a combination analgesic regimen investigated by Assiut University for the management of postoperative pain, particularly in patients undergoing major abdominal cancer surgeries. Bupivacaine is a long-acting amide-type local anesthetic that works by binding to and blocking voltage-gated sodium channels on the internal surface of nerve cell membranes, preventing the generation and conduction of nerve impulses. Magnesium sulfate is utilized as an adjuvant in regional anesthesia (such as external oblique intercostal plane blocks and quadratus lumborum blocks) due to its properties as a non-competitive NMDA receptor antagonist and its ability to block calcium channels. This combination aims to prolong the duration of sensory and motor blockade, improve the quality of postoperative analgesia, and reduce the overall consumption of systemic opioids like morphine.
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