Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
Abstract Background: The use of intraperitoneally administered local anesthetics as a sole agent or in combination with various types of analgesics has been used increasingly recently. The goal of this study was to compare the effects of intraperitoneal bupivacaine, bupivacaine with magnesium sulfat...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | Bali Journal of Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.4103/bjoa.bjoa_34_24 |
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| Summary: | Abstract Background: The use of intraperitoneally administered local anesthetics as a sole agent or in combination with various types of analgesics has been used increasingly recently. The goal of this study was to compare the effects of intraperitoneal bupivacaine, bupivacaine with magnesium sulfate, and bupivacaine with tramadol for postoperative analgesia in laparoscopic cholecystectomy. Materials and Methods: We carried out this prospective, double-blind, randomized trial in 90 patients aged between 20 and 60 years who were randomly divided into three groups. Group B received 25 mL (0.25%) bupivacaine, group T received 25 mL (0.25%) bupivacaine and 100 mg tramadol, and group M received 25 mL of 0.25% bupivacaine and 50 mg/kg of MgSO4. All drugs were administered by intraperitoneal instillation. The Visual Analog Scale (VAS), time of first rescue analgesia, and total dose of rescue analgesia were compared. Results: VAS was significantly higher in group B than in group M at all observed times. The significance also showed when comparing VAS between groups M and T at 4 h (P < 0.001), 6 h (P < 0.001), 12 h (P = 0.001), and 24 h (P < 0.001) postoperatively. Group M showed the longest time to rescue analgesia (22.57 ± 0.97 h, P < 0.001) and the lowest dose requirement of rescue analgesia (P < 0.001). Furthermore, the incidence of postoperative nausea and vomiting was comparable (5 vs. 1 vs. 5, respectively, P = 0.191). Conclusion: Intraperitoneal instillation of MgSO4 and bupivacaine improved postoperative pain scores, decreased analgesic requirements, and reduced consumption of rescue analgesics compared to both intraperitoneal instillation of sole bupivacaine and bupivacaine–tramadol combination. |
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| ISSN: | 2549-2276 |