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Category: Volume 07 Issue 03 March 2019
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Title: Effect of Intra Operative Magnesium Sulphate on Pain Relief after Laparoscopic Cholecystectomy

Authors: Dr P.Sudha Poornima, Dr D. Kailashini

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.168

Abstract

Background and Aim: Laparoscopic cholecystectomy is the gold standard for treatment of symptomatic cholelithiasis. Laparoscopic cholecystectomy procedure offers several advantages such as a reduction in stress response, postoperative pain, short recovery time, and cosmetic appearance. we aimed at evaluating the postoperative analgesic efficiency of magnesium sulphate as pre emptive analgesic in patients undergoing laparoscopic cholecystectomy.

Materials and Methods: Sixty patients with ASA Grade I and Grade II undergoing laparoscopic cholecystectomy were included in study and divided in two groups. Patients in magnesium group(group MS)received i.v MGSO4 50 mg/kg in 100ml of 0.9% normal saline during Pre induction time and patients in the control group (group NS) received 100ml of 0.9% normal saline .Pre medicated with injection glycopyrolate 0.01mg/kg,inj midazolam0.03 mg/kg, inj. fentanyl 2µgm/kg was given to both groups. Effect of Magnesium sulphate infusion on post operative analgesic efficiency based on visual analogscoring, total tramadol consumption during first postoperative day, time for first rescue analgesia, post operative haemodynamic variables heart rate and MAP were assessed.

Result: Comparison of VAS scores ,at the time of extubation i.e 0 hr,2 hr,4 hr has statistically significance of P value i.e>0.05. With lower VAS scores in magnesium group compared to normal saline group. At 8 hr, 12 hr,24 hr has no statistical significant value between two groups.(P Value>0.05) Post operative tramadol consumpotion has significant difference (P<0.05) between magnesium sulphate and normal saline group. Tramadol consumption was more in normal saline group than magnesium group. There is a significant P value (P<0.05) for time for first rescue analgesia between magnesium and normal saline groups. The time taken for rescue analgesia was longer duration in magnesium group than normal saline group. With comparison of heart rates in 0 hr,2 hr postoperative period there is a statistically significant P value (P<0.05)observed. At 4 hr,8 hr,12 hr,24 hr there is no significance between among groups.(P value >0.05 Magnesium sulphate group has lesser incidence of side effects like shivering and post operative nausea and vomiting ,but more patients experienced sedation than normal saline group.

Conclusion: magnesium sulphate was a good pre-emptive analgesic that has better VAS scores and reduces the postoperative tramadol consumption than normal saline group with minimal side effects.

Keywords: laparoscopic cholecystectomy, preemptive analgesia, magnesium sulphate.

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Corresponding Author

Dr P.Sudha Poornima

Department of Anaesthesiology, Andhra Medical College, Visakhapatnam