Background. Magnesium sulfate has analgesic properties during the postoperative period. However, there is a knowledge gap in pharmacology related to the use of the real, ideal, or corrected ideal body weight to calculate its dose in obese patients. This trial compared postoperative analgesia using actual and corrected ideal body weight. Methods. Seventy-five obese patients scheduled to undergo laparoscopic gastroplasty or cholecystectomy under general anesthesia were randomly assigned to three groups. The patients in the control group did not receive magnesium sulfate; the other two groups received magnesium sulfate at 40 mg·kg−1 of actual body weight or corrected ideal body weight. Results. In patients with body mass index >30 mg·kg−2 (mean body mass index ranging from 32.964 kg·m−2 to 33.985 kg·m−2, according to the groups) scheduled for video laparoscopic cholecystectomy, there were no differences in the blood magnesium concentrations in the groups receiving magnesium sulfate throughout the study, regardless of whether the strategy to calculate its dose was based on total or corrected ideal body weight. Patients in the groups receiving magnesium sulfate showed a significant reduction in morphine consumption ( p ≤ 0.001 ) and pain scores ( p = 0.006 ) in the postoperative period compared to those in the control group. There were no significant differences in morphine consumption ( p = 0.323 ) or pain scores ( p = 0.082 ) between the two groups receiving magnesium sulfate. There were no differences in the total duration of neuromuscular block induced by cisatracurium among the three groups ( p = 0.181 ). Conclusions. Magnesium sulfate decreased postoperative pain and morphine consumption without affecting the recovery time of cisatracurium in obese patients undergoing laparoscopic cholecystectomy. Strategies to calculate the dose based on the actual or corrected ideal body weight had similar outcomes related to analgesia and the resulting blood magnesium concentration. However, as the sample in this trial presented body mass indices ranging from 30.11 kg·m−2 to 47.11 kg/m−2, further studies are needed to confirm these findings in more obese patients, easily found in centers specialized.
BACKGROUNDMagnesium sulfate has analgesic properties in the postoperative period. Among obese patients, there is a gap in the knowledge of its pharmacology related to the use of real, ideal, or corrected ideal body weight in calculating its dose. This trial compared postoperative analgesia using actual and corrected ideal body weight.METHODSSeventy-five obese patients scheduled to undergo laparoscopic cholecystectomy under general anesthesia were randomly assigned to three groups. Patients in the control group received no magnesium sulfate; patients in the other two groups received magnesium sulfate 40 mg·kg− 1 of actual body weight or corrected ideal body weight. A ten nonobese patients group helped us as a model of the expected blood magnesium concentration after magnesium sulfate administration in general population.RESULTSPatients from the groups receiving magnesium sulfate showed significant reduction in morphine consumption (p ≤ 0.001) and pain scores (p = 0.006) in the postoperative period compared to the control group. There was no significant difference in the consumption of morphine (p = 0.323) or pain scores (p = 0.082) between these groups. There was no difference in the total duration of neuromuscular block induced by cisatracurium among the three groups (p = 0.181) or in the blood magnesium concentrations throughout the study.CONCLUSIONSMagnesium sulfate decreased postoperative pain and morphine consumption without affecting cisatracurium recovery time in obese patients undergoing laparoscopic cholecystectomy. Analgesic profile was similar in groups receiving magnesium sulfate calculated through real or corrected ideal body weight.TRIAL REGISTRATIONclinicaltrials.gov NCT04003688. (Date of registration: June 24, 2019)
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