September, 2017 2017; Vol1; Issue8 http://iamresearcher.online To Cite This Article: Fatma Gad Elrab ELsayed Askar, Jehan Ahmed Sayed Ahmed, Mahmoud Bahaa Eldean Mousa Hassan. Effect of Adding Magnesium Sulphate to Pediatric Caudal Bupivacaine on Hemodynamics Parameters and Surgical Stress: Randomized Double-Blind Control Study. International Annals of Medicine. 2017;1(8). https://doi.org/10.24087/IAM.2017.1.8.262 Effect of Adding Magnesium Sulphate to Pediatric Caudal Bupivacaine on Hemodynamics Parameters and Surgical Stress: Randomized Double-Blind Control Study Fatma Gad Elrab ELsayed Askar, Jehan Ahmed Sayed Ahmed, Mahmoud Bahaa Eldean Mousa Hassan Intensive care and pain management, faculty of medicine, Assiut Universiy, Egypt Corresponding Author: Mahmoud Bahaa el dean Mousa Hassan dr.mahmoudbahaa@aun.edu.eg ABSTRACT Background: Caudal anesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants have been utilized with local anesthetic to prolong duration of post-operative analgesia of caudal block in pediatric patients, but with variable results. Aim and Objective: This study is conducted to evaluate the hemodynamics effects and surgical stress response of caudal magnesium sulfate with bupivacaine in children undergoing lower abdominal surgeries. Methods: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 children ASA classification I and II, aged 1 year to 6 years scheduled for lower abdominal surgeries randomized into one of two groups. after inhalation induction of general anesthesia, standard caudal block was done the participants were randomized into one of two groups either receive 1ml volume containing 50mg of magnesium sulfate (group Mg) added to 1ml /kg bupivacaine 0.25% or 1ml saline as placebo added to the same dose of bupivacaine in group (C). Postoperative pain assessed by FLACC score (acronym for Face, Legs, Activity, Cry and CONSOL ability) and duration of analgesia, postoperative sedation as well as hemodynamic parameters were compared between the two groups. Results: Group Mg had significantly lower FLACC score than group C in the first six postoperative hours. The sedation score was significantly higher only during the first postoperative hours in group Mg compared to group C. There was no statistically significant difference between groups about hemodynamic parameters at any time during the study period. Conclusion: Caudal magnesium sulfate 50mg enhance caudal block and prolongs duration of analgesia with bupivacaine in pediatric patient undergoing lower abdominal surgeries under general anesthesia with minimum adverse effects. Keywords: Caudal bupivacaine – Magnesium on postoperative analgesia – Stress response in children 1. INTRODUCTION Postoperative pain in children is difficult to assess and associated with strong emotional component (1) Caudal epidural anesthesia is a common technique providing intra and postoperative analgesia in pediatric infra umbilical surgical procedures (2) . Prolongation of caudal analgesia using a “single-shot” technique has been achieved by the addition of various adjuvant such as opioids, ketamine, clonidine, and dexmedetomidine (3) . However, their use has been limited