Effect of intraperitoneal magnesium sulfate on hemodynamic changes and its analgesic and antiemetic effect in laparoscopic cholecystectomy

Background Laparoscopic cholecystectomy is now a routinely performed procedure that has replaced conventional open cholecystectomy. Magnesium sulfate (MgSO4) has been used in the management of postoperative pain through different routes. This prospective randomized, double-blind study aimed to assess the effect of MgSO4 on hemodynamic response and its analgesic and antiemetic effects in patients undergoing laparoscopic cholecystectomy. Patients and methods Sixty adult patients scheduled for elective cholecystectomy under general anesthesia were randomly allocated into two groups: group M and group C. Patients in group M received 20 ml of MgSO4 10% instilled intraperitoneally after pneumoperitoneum was created before any dissection, whereas group C patients received the same volume of 0.9% sodium chloride. Results Hemodynamic parameters were significantly higher in group C compared with group M at 10, 20, and 30 min after pneumoperitoneum, and at the time of extubation. Recovery characteristics in terms of extubation time (9.70 ± 1.12 vs. 6.77 ± 0.73), emergence time (19.83 ± 1.44 vs. 15.93 ± 1.60), and time to reach full Aldrete score (43.03 ± 8 vs. 21.4 ± 4.7) were significantly longer in group M compared with group C. Mean pain scores (visual analog scale) were significantly lower in group M compared with group C during the first 6 postoperative hours, and the time to fi rst analgesic requirement was longer in group M (9.2 ± 3 h) compared with group C (2.4 ± 1.3 h). Postoperative nausea was significantly higher in group C (63.3%) compared with group M (36.6%). There was no incidence of vomiting in group M compared with 13.3% in group C. Conclusion Intraperitoneal instillation of MgSO4 attenuated the hemodynamic stress response to pneumoperitoneum, as well as reduced postoperative pain, nausea, and vomiting in patients undergoing laparoscopic cholecystectomy.