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

Anaesthesia, Pain & Intensive Care

article

Mostafa Galal Mahrous El-Sesy¹  Amr E. Abdel Hameed¹  Abdelaziz A. Abdelaziz¹  Ibrahim M. Ahmed¹  Ahmed M. Elhennawy¹ 

[1] Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University

关键词: 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;   

DOI  :  10.35975/apic.v26i4.1947

学科分类：社会科学、人文和艺术（综合）

来源: THK

【 摘 要 】

Background: Laparoscopic bariatric surgery has become a regular procedure, and it has largely replaced traditionalopen surgery. Patients experience postoperative pain even after laparoscopic surgery, although the intensity is lowcompared to open surgery. We compared the effectiveness of intravenous (IV) vs. intraperitoneal (IP) magnesiumsulphate (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; theIV 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 itstotal postoperative consumption during the first 24 h was recorded based on VAS score. Postoperative nausea andvomiting (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 vomitingscores 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 ofpostoperative pain and hemodynamic response associated with pneumoperitoneum, and results in less PONV whenused in laparoscopic minigastric bypass patients.

【 授权许可】

CC BY-NC