Congenital absence of the vagina was first mentioned by Realdus Columbus in 1572 (quoted by Bryan, Nigro, and Counseller, 1949). The incidence has been variously reported as 1 in 4,000 female patients (Bryan et al., 1949), 1 in 5,000 births (Engstad, 1917), and 6 in 125,000 female hospital admissions (Owens, 1942). The largest series was reported by Phelan, Counseller, and Greene (1953), who saw 129 patients with absence of the Abnormalities Found on I.V.P. and X-ray Film of Skeleton Clinical Signs

Background: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO 4 ) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. Aims: The aim of this study was to evaluate the effect of MgSO 4 and ketamine on the duration of analgesia in brachial block. Settings and Design: This was a prospective, randomized, controlled double-blind study. Materials and Methods: One hundred and five adult patients were randomly divided into three groups: Group I = 27 mL of 0.5% ropivacaine; Group II = 27 mL of 0.5% ropivacaine + 250 mg MgSO 4 ; and Group II = 27 mL of 0.5% ropivacaine + 2 mg.kg −1 ketamine. Normal saline was added to make a total volume of 30 mL. The onset and duration of the sensorimotor blockade, quality and duration of postoperative analgesia, and adverse effects were assessed. Statistical Analysis: Statistical analysis was performed using SPSS, version 17.0 software (SPSS, Inc., Chicago, IL, USA). Chi-square test was used for nonparametric and ANOVA for parametric data. Post hoc Student's paired t -test was applied wherever indicated. The results were expressed as mean and standard deviation or numbers (%). P < 0.05 was considered as statistically significant. Results: The duration of analgesia was significantly longer in Group II (8.78 ± 0.97 h) compared to Group I (6.76 ± 0.92 h; P < 0.001) and Group III (7.1 ± 0.89 h; P < 0.001). Intervention groups had lower postoperative visual analog scores at 8, 12, and 24 h compared to the control group. Sedation, nystagmus, and hallucinations were observed in Group III. Conclusion: The addition of MgSO 4 to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia. MgSO 4 improves the quality of postoperative analgesia with lesser incidence of side effects when compared to ketamine.

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