الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Traumatic injuries to the hand and forearm are becoming more recognised as a serious public health issue. There are two factors that make such traumatic injuries dangerous as a clinical entity. First, they are frequently seen in practise . Second, a large majority of patients are unable to return to work, placing a considerable financial burden on the community.
Patients with upper limb injuries are using regional anaesthetic more frequently. It is a sensible decision because it eliminates the negative effects of opioids, powerful volatile anaesthetics, and muscle relaxants used in general anaesthesia.
For perioperative anaesthesia and analgesia during surgery on the upper extremity, the brachial plexus block is a well-liked and frequently used regional nerve block technique, while the axillary approach provides
a dependable and secure approach for procedures of the hand and forearm.
Brachial plexus block quality is enhanced by ultrasound guiding. Using ultrasound assistance, it is now possible to visualise the plexus, axillary artery and vein with increased safety and reduced risk of problems.
Recently great efforts have been established to improve the results of block with various adjuvant drugs. So medications such as opioids, epinephrine, dexamethasone, and ketamine along with local anesthetics might show to be more effective.
Magnesium sulphate can be used as adjuvants to local anaesthetics in peripheral nerve blockade. Magnesium has a role in different physiological actions that include vascular tone, transmembrane ion flux, control of calcium channel gating, neuronal activity, heart excitability, and neurotransmitter release.
The aim of the work is to Study the effect of adding magnesium sulphate to bupivacaine in axillary brachial plexus and intercostobrachial nerve blocks as regard the duration of postoperative analgesia, Onset, grade and duration of sensory and motor blocks, incidence of tourniquet pain and total opioid consumption.