Publication:

The effects of magnesium sulphate on haemodynamic stress response to pneumoperitonium in laparoscopic cholecystectomy: a double blinded randomised controlled study

Background To study the effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum during laparoscopic cholecystectomy and to study the side effects of the drug of any.

Methods Patients were randomly allocated into two groups of 40 each. Automated NIBP, Heart rate, Nausea, headache was noted. Magnesium ion concentration was measured. Chi square test was used to test the association between different study variables under study. Corrected test was used in case of any one of the cell frequency was found less than 5 in the bivariate frequency distribution. Fisher’s Exact Test was also used in the case where the test could not be applied. Test of proportion (Z-test) was used to test the significant difference between two proportions. t-test was used to test the significant difference between means. P≤0.05 was considered statistically significant.

Results Patients’ characteristics were comparable in both groups. Most data related to surgery and anaesthesia were comparable in both groups. The MAP of group N (control) was significantly higher than that of group M throughout surgery (P5,P10,P20,P30, and at extubation) except at baseline and at the time of PP (P0). The MAP is better maintained in M group. Usage of GTN in the control group was significantly higher. HR of the control group was significantly higher after 20 min (P20) of pneumoperitoneum and after extubation. There was significantly more incidence of nausea and vomiting in the control group.

Conclusions Use of magnesium sulphate just before pneumoperitoneum is very useful for attenuating haemodynamic alterations to pneumoperitoneum and the requirement of antihypertensive GTN is significantly much less compared to the control group during laparoscopic surgery without increasing any adverse outcome.