The Beneficial Effects of Adding Magnesium Sulphate to General Anesthesia for Laparoscopic Sleeve Gastrectomy

Abstract

Background: Obesity is a significant health issue. It was estimated that about 700 million were obese. Some call this trend the “New World Syndrome”. Aim of the work: The study aims to compare between intravenous injections of one to two grams of magnesium sulfate [MgSO4] in patients scheduled for elective laparoscopic sleeve gastrectomy. Patients and methods: It is a multicenter study, which included 800 patients who were scheduled for elective laparoscopic sleeve gastrectomy under general anesthesia; all patients were randomly grouped into two equal groups [n = 400]. The first group for one gram and the second group for two grams of MgSO4 over 10 minutes immediately after induction of anesthesia and before starting surgery. Then, all were assessed postoperatively for different variables. Results: The duration of full recovery was significantly shorter, intensive care unit admission and postoperative pain immediately after recovery till the end of the first 18 hours was lower in M2 when compared to the M1 group. Postoperative respiratory depression, nausea, and vomiting were significantly decreased. The number of early ambulation was significantly increased, while the length of stay was significantly reduced in the M2 group. Intraoperative bleeding and pain after 18 hours showed a non-significant difference between both groups. Postoperative bleeding was reported in two patients in the M2 group and returning to the operating room again within 6 hours and managed by blood transfusion and surgical laparoscopy. No patients suffered from deep vein thrombosis or any other complications. Conclusion: Adding MgSO4 to general anesthesia in laparoscopic sleeve gastrectomy had beneficial effects, which increased by increasing the dose from one to two grams.

Keywords

• general anesthesia
• obesity
• magnesium sulphate
• laparoscopic
• sleeve gastrectomy