The Effects of Magnesium Sulfate Loading on Hemodynamic Parameters During Laparoscopic Cholecystectomy: Randomized Controlled Trial

Abstract

Background: This study was designed to investigate the effect of intravenous magnesium sulfate on hemodynamic changes induced by pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. Methods: A randomized, placebo controlled study was performed on 52 ASA class I or II aged 20-70 years patients undergoing laparoscopic cholecystectomy with pneumoperitoneum with carbon dioxide. Before induction, Magnesium group received 50 mcg.kg-1 magnesium sulfate, within 10 minutes, in 100 ml of normal saline and control group received 100 ml normal saline. Hemodynamic variables were recorded before induction, before the infusion of magnesium sulfate, during intubation, during pneumoperitoneum and finally during extubation, every 10 minutes. Postoperative pain and other complications were recorded in post anesthesia care unit (PACU) also. Results: Variations in heart rate and mean arterial pressure between the two groups during pneumoperitoneum were not significantly different (P>0.05). Propofol consumption in the magnesium group compared with the control group was significantly decreased (P<0.05). The prescribed dose of TNG and total amount of administrated TNG (SUM), both were significantly higher in control group than in the magnesium group (respectively P=0.02 and P=0.042). In PACU, patients in the magnesium presented lower shivering, nausea vomiting and post operative pain than the control group (P <0.05). Conclusion: Magnesium sulfate reduces the amount of anesthetic drug (propofol), TNG and intraoperative blood pressure, during pneumoperitoneum induced by laparoscopy. The postoperative pain of laparoscopy and anesthesia side effects such as nausea, vomiting and shivering were blunted, with bolus administration of magnesium sulfate before induction of anesthesia.

Keywords

• carbon dioxide
• hemodynamics
• laparoscopy
• magnesium sulfate