The goal of postoperative pain management is the provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using regional anethesia.

This study aimed to assess the analgesic effect of adding dexamethasone or magnesium sulphate with bupivacaine in ultrasound-guided QLB to prolong its duration in patients undergoing open abdominal surgeries in the early postoperative period regarding pain relief After approval of the ethical committees in Ain Shams University Hospitals, patients undergoing open abdominal surgeries were included in the study, and were divided into three groups (n=22; each); group M, D and group C. In Group A, patients (n=22) received 20 ml bupivacaine 0.25% plus 5 ml of 10% MgSO. In group B, patients (n=22) received 20 ml bupivacaine 0.25% plus 8 mg dexamethasone (2 ml) plus 3 ml 0.9% NaCl. In group C (control), patients (n=22) received 20 ml bupivacaine plus 5 ml 0.9% NaCl.

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) physical status I or II
• aged 18 to 65 years
• body weight ≥ 60 kg and ≤ 90 kg
• scheduled for open abdominal surgeries

Exclusion Criteria:

• Patients' refusal to participate in the study
• history of allergy to the medications used in the study
• hepatic disease
• renal disease
• known neurologic disorders
• psychiatric disorder
• chronic treatment with calcium channel blockers
• hyper-magnesemia
• coagulopathy
• anatomical abnormalities
• hemodynamic instability
• local infection
• suspected intra- abdominal sepsis