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

Ali, Rania M; Rabie, Ahmed; Elshalakany, Nirvana Ahmed; Gindy, Tarek M El

doi:10.4103/1687-7934.156661

Cited by 6 publications

(8 citation statements)

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“…Ali et al . [11] administered 20 ml MgSO 4 10% by IP instillation after creation of pneumoperitoneum in patients undergoing laparoscopic cholecystectomy, and they found that the use of magnesium was associated with attenuation of adverse hemodynamic stress response compared to control group. The decrease in hemodynamic parameters was more obvious in IV Group than IP MgSO 4 Group after pneumoperitoneum, which might have been attributed to the immediate onset of action as well as the rapid rise of serum magnesium levels in IV MgSO 4 group.…”

Section: Discussionmentioning

confidence: 99%

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Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy–A prospective randomized study

Mourad

Arafa

2019

J Anaesthesiol Clin Pharmacol

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Background and Aims: Hemodynamic changes to pneumoperitoneum and postoperative pain can be detrimental in obese patients; we investigated whether intravenous (IV) or intraperitoneal (IP) magnesium sulphate (MgSo 4 ) administration could attenuate the hemodynamic stress response to pneumoperitoneum and improve postoperative pain control after laparoscopic sleeve gastrectomy (LSG). Material and Methods: In total, 120 patients scheduled for LSG were randomized to either, control group (Group C, IV and IP saline), Group I (IV 30 mg/kg MgSo 4 ), or Group P (IP 30 mg/kg MgSo 4 ). Outcome variables were mean arterial pressure (MAP), heart rate (HR), postoperative pain score, total analgesic consumption, and incidence of adverse events. Results: MAP and HR were significantly lower in Groups I and P than that in control group. Pain score was better in Groups I and P than in control group up to 2 h postoperative ( P = 0.023, 0.010, respectively); it was significantly lower in Group P than other two groups at 4 h postoperative ( P <0.001). Significantly, reduced postoperative analgesic consumption with delayed onset to first analgesic request were observed in magnesium groups compared to control ( P = 0.001, respectively). Moreover, onset to first analgesic request was longer in Group P than Group I ( P = 0.001). No serious side effects were noticed. Conclusion: The IV and IP administration of MgSo 4 significantly attenuated the circulatory response to pneumoperitoneum and reduced postoperative pain as well as opioid consumption as compared to controls in obese patients undergoing LSG with no serious adverse effects.

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Section: Discussionmentioning

confidence: 99%

“…Magnesium sulphate (MgSo 4 ), N-Methyl-D-aspartate (NMDA) receptor antagonist, has been administered by different routes to attenuate pneumoperitoneum associated hemodynamic response and to reduce postoperative pain. [1112]…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy–A prospective randomized study

Mourad

Arafa

2019

J Anaesthesiol Clin Pharmacol

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“…Nevertheless, there is no current information available on the direct effect of MgSO4 on PONV. 2,9 On the other…”

Section: Discussionmentioning

confidence: 99%

“…Our results were similar to those reported by El Mourad and Arafa about the benefits of IV and IP intake of MgSO4 in attenuating the hemodynamic alterations created due to pneumoperitoneum. 2 9 The IP intake of local anesthetics with or without adjuvant was reported to be efficient in enhancing perception of pain during different laparoscopic surgeries. This might be caused by blockage of visceral afferent pain transmission.…”

Section: Discussionmentioning

confidence: 99%

“…11 Ali et al also reported that sedation score was significantly higher in patients receiving IV MgSO4 in comparison with controls during the first 3 h postoperatively. 9 The timing of instillation of local anesthetic and adjuvant through the procedure is still debatable. Barczynski et al recommended early instillation of intraperitoneal local anesthetics before creation of pneumoperitoneum to provide better hemodynamic response and postoperative pain management in comparison with infusion within the closing stages of the procedure.…”

Section: Discussionmentioning

confidence: 99%

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A comparative study between intravenous and intraperitoneal magnesium sulphate for pain management in laparoscopic mini gastric bypass: a randomized clinical trial

El-Sesy¹,

Hameed²,

Abdelaziz³

et al. 2022

Anaesth. pain intensive care

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Abstract Background: Laparoscopic bariatric surgery has become a regular procedure, and it has largely replaced traditional open surgery. Patients experience postoperative pain even after laparoscopic surgery, although the intensity is low compared to open surgery. We compared the effectiveness of intravenous (IV) vs. intraperitoneal (IP) magnesium sulphate (MgSO4) injection in pain management in laparoscopic mini-gastric bypass surgery. Methodology: We selected 100 patients based on convenient sampling and randomly divided into two groups; the IV group (50 patients) received MgSO4 50 mg/kg in 250 ml normal intravenously, and the IP group (50 patients) received MgSO4 50 mg/kg in 30 ml normal saline intraperitoneally. Nalbuphine was used as rescue analgesic and its total postoperative consumption during the first 24 h was recorded based on VAS score. Postoperative nausea and vomiting (PONV), sedation score and hemodynamic changes with pneumoperitoneum were also assessed. Results: Total nalbuphine consumption postoperatively was more in IV group than IP group (12 ± 3.03 mg vs. 8.3 ± 2.8 mg; P < 0.001). Postoperative pain score was significantly lower in IP group in comparison to IV group (P < 0.001). Intraoperative hypotension and bradycardia were significantly more (P = 0.03) in IV group (21% and 17% respectively) compared to IP group (10% and 7% respectively). Postoperative sedation and nausea and vomiting scores were reduced in IP group compared to IV group, the difference being highly significant (P < 0.001). Conclusion: Intraperitoneal MgSO4 instillation has better results than intravenous infusion in attenuation of postoperative pain and hemodynamic response associated with pneumoperitoneum, and results in less PONV when used in laparoscopic minigastric bypass patients. Key words: Analgesics / administration & dosage; Analgesics / pharmacology; Analgesics / therapeutic use; Bariatric; Magnesium Sulfate / administration & dosage; Magnesium Sulfate / pharmacokinetics; Magnesium Sulfate / therapeutic use; Mini-gastric bypass; Pain management; Pneumoperitoneum Citation: El-Sesy MG, Abdel Hameed AE, Abdelaziz AA, Ahmed IM, Elhennawy AM. A comparative study between intravenous and intraperitoneal magnesium sulphate for pain management in laparoscopic mini gastric bypass: a randomized clinical trial. Anaesth. pain intensive care 2022;26(4):450-457; DOI: 10.35975/apic.v26i4.1947 Received: April 18, 2022; Reviewed: June 16, 2022; Accepted: July 10, 2022

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Efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal bupivacaine in pediatric laparoscopic surgery: a randomized clinical trial

Moeen

Wahba

Mandour

et al. 2022

Brazilian Journal of Anesthesiology (English Edition)

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

Cited by 6 publications

References 0 publications

Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy–A prospective randomized study

Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy–A prospective randomized study

A comparative study between intravenous and intraperitoneal magnesium sulphate for pain management in laparoscopic mini gastric bypass: a randomized clinical trial

Efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal bupivacaine in pediatric laparoscopic surgery: a randomized clinical trial

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