Clinical Observation Of Magnesium Sulfate During Laparoscopic Cholecystectomy

Objective: This randomized, placebo-controlled study was designed toinvestigate the effect of magnesium sulphate on the stress response duringlaparoscopic cholecystectomy; and compared with remifentanil. In order toexploring the effects and safety of laparoscopic cholecystectomy for magnesiumsulfate.Methods:45patients selective laparoscopic cholecystectomy under generalanesthesia, ASA gradeⅠ～Ⅱ, were ramdomly devided into three group.The group Mreceived magnesium sulfate30mg／kg,administered as a slow iv bolus over20minperiod before the induction of anaesthesia, and15mg／(kg·h)by continuousintravenous infusion during the operation. R group with remifentanil pump, with therate of0.2ug/(kg·min) to the end of the operation. The same volume of saline wasadministered to the group C. Each group was induced with midazolum0.05～0.1mg/kg, propofol1.5mg/kg,fentanyl2ug/kg and vecuronium0.1mg/kg intravenousinjection. Anesthesia was maintained with1%～2%sevoflurane, and propofolconstant pump to suture skin. SBP,DBP and HR were record after10min resting inoperating room (T0), before anesthesia induced (T₁),5min after setting uppneumoperitoneum (T₂),10min after stablishing pneumoperitoneum (T3),20minafter setting up pneumoperitoneum (T₄),30min after establishing pneumoperitoneum(T₅),1min after tracheal extubation (T₆). Blood samples were taken at T₀,T₂,T3,T₆to determination the concentraction of E and NE. The time for awakening andtracheal extubating, adverse effects during intraoperative were recorded. And usingVAS evaluation method to grade postoperative pain.Result: There were no significant Statistically differences in Age,Sex,Weightand the time for pneumoperitoneum (P>0．05). SBP,DBP of group M were lowerthan group R and group C at T₁(P＜0.05). SBP,DBP and HR of group M and groupR were lower than group C at T₂to T₅(P＜0.05),but there were no significantdifference between group M and group R(P>0．05). SBP,DBP and HR of group M at T6were lower than group R and group C (P＜0.05),but there was no differencebetween group R and group C. And the concentration of E,NE in group C weresignificantly higher at T₂,T₃than group M and group R(P＜0.05).The concentrationof E,NE of group R at T6were significantly higher than group M and group C(P＜0.05). The time for awakening and tracheal extubating in group M was longer thangroup C and group R(P＜0.05). Finaly, group M suffers less postoperative pain thangroup R and group C(P＜0.05).Compared with T0, the SBP,DBP and HR of group C were significantlyincreased at T₂to T₅(P＜0.05);SBP and DBP of group M were lower at T1(P＜0.05);SBP,DBP and HR of group R were higher at T6(P＜0.05).And the plasmaconcentration of E and NE were higher in group C at T₂,T₃(P＜0.05).Conclusion: The patients received continuous intravenous of magnesium sulfateduring the operation. It can restrain the stress of response caused bypneumoperitoneum, and reduce catecholamine releasing, thus provide steady bloodpressure and heart rate, which effect is similar to remifentanil. And magnesiumsulfate can reduce the postoperative pain in patients.