Lidocaine vs. magnesium: effect on analgesia after a laparoscopic
cholecystectomy.
Author(s): Saadawy IM(1), Kaki AM, Abd El Latif AA, Abd-Elmaksoud AM, Tolba OM.
Affiliation(s): Author information:
(1)Department of Anaesthesia, King Abdulaziz University, Jeddah, Saudi Arabia.
ninaeg2001@yahoo.com
Publication date & source: 2010, Acta Anaesthesiol Scand. , 54(5):549-56
BACKGROUND: This double-blinded study aimed at evaluating and comparing the
effects of magnesium and lidocaine on pain, analgesic requirements, bowel
function, and quality of sleep in patients undergoing a laparoscopic
cholecystectomy (LC).
METHODS: Patients were randomized into three groups (n=40 each). Group M received
magnesium sulfate 50 mg/kg intravenously (i.v.), followed by 25 mg/kg/h i.v.,
group L received lidocaine 2 mg/kg i.v., followed by 2 mg/kg/h i.v., and group P
received saline i.v. Bolus doses were given over 15 min before induction of
anesthesia, followed by an i.v. infusion through the end of surgery.
Intraoperative fentanyl consumption and averaged end-tidal sevoflurane
concentration were recorded. Abdominal and shoulder pain were evaluated up to 24
h using a visual analog scale (VAS). Morphine consumption was recorded at 2 and
24 h, together with quality of sleep and time of first flatus.
RESULTS: Lidocaine or magnesium reduced anesthetic requirements (P<0.01), pain
scores (P<0.05), and morphine consumption (P<0.001) relative to the control
group. Lidocaine resulted in lower morphine consumption at 2 h [4.9 + or - 2.3
vs. 6.8 + or - 2.8 (P<0.05)] and lower abdominal VAS scores compared with
magnesium (1.8 + or - 0.8 vs. 3.2 + or - 0.9, 2.2 + or - 1 vs. 3.6 + or - 1.6,
and 2.1 + or - 1.4 vs. 3.3 + or - 1.9) at 2, 6, and 12 h, respectively (P<0.05).
Lidocaine was associated with earlier return of bowel function and magnesium was
associated with better sleep quality (P<0.05).
CONCLUSION: I.v. lidocaine and magnesium improved post-operative analgesia and
reduced intraoperative and post-operative opioid requirements in patients
undergoing LC. The improvement of quality of recovery might facilitate rapid
hospital discharge.
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