Introduction: Magnesium sulphate can prolong the effect of local anaesthetics. Adenosine has not been compared to other local anaesthetics adjuvants. In the present study we aimed to compare the effect of adding magnesium sulphate and adenosine to bupivacaine for pectoral nerves block. Patients and Methods: In this randomized controlled trial, 90 females scheduled for breast surgery were included. Patients were divided into three groups. Patients received general anaesthesia with pectoral nerves block. Group C, A, and M had bupivacaine only, bupivacaine + adenosine, and bupivaciane + magnesium sulphate respectively. Post-operative visual analogue score, block duration, post-operative morphine consumption, sedation score, and peri-operative haemodynamic changes were recorded. Results: Visual analog score was lower in Group M compared to other groups. Group A and M showed significant longer duration of the block. Group M showed significant longer duration of action than Group A (p = 0.034). The total peri-operative morphine used was higher in Group C (p < 0.05). Post-operative Ramsay sedation score was significantly lower in Group A during the first two hours post-operatively (p > 0.05). Conclusions: Local anaesthetic adjuvants such as adenosine or magnesium sulphate can improve pectoral nerves block characteristics. Magnesium sulphate has an advantage over adenosine by increasing the block duration.
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