Magnesium sulphate attenuates arterial pressure increase during laparoscopic cholecystectomy.
BACKGROUND
Magnesium is well known to inhibit catecholamine release and attenuate vasopressin-stimulated vasoconstriction. We investigated whether i.v. magnesium sulphate attenuates the haemodynamic stress responses to pneumoperitoneum by changing neurohumoral responses during laparoscopic cholecystectomy.


METHODS
Thirty-two patients undergoing laparoscopic cholecystectomy were randomly assigned to two groups; a control group was given saline, and a magnesium group received magnesium sulphate 50 mg kg(-1) immediately before pneumoperitoneum. Arterial pressure, heart rate, serum magnesium, plasma renin activity (PRA), and catecholamine, cortisol, and vasopressin levels were measured.


RESULTS
Systolic and diastolic arterial pressures were greater in the control group (P<0.05) than in the magnesium group at 10, 20, and 30 min post-pneumoperitoneum. Norepinephrine or epinephrine levels [pg ml(-1), mean (SD)] were higher in the control group than in the magnesium group at 5 [211 (37) vs 138 (18)] or 10 min [59 (19) vs 39 (9)] post-pneumoperitoneum, respectively (P<0.05). In the control group, vasopressin levels [pg ml(-1), mean (SD)] were higher compared with the magnesium group at 5 [64 (18) vs 35 (9), P<0.01] and 10 min [65 (18) vs 47 (11), P<0.05] post-pneumoperitoneum. There were no significant differences between the groups in PRA and cortisol levels.


CONCLUSIONS
I.V. magnesium sulphate before pneumoperitoneum attenuates arterial pressure increases during laparoscopic cholecystectomy. This attenuation is apparently related to reductions in the release of catecholamine, vasopressin, or both.
Jee
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D
Department of Anaesthesiology and Pain Medicine, College of Medicine, Yeungnam University, 317-1 Daemyung Dong, Namgu, Daegu 705-717, Republic of Korea.
Lee
D
D
Yun
S
S
Lee
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C
D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004311:Double-Blind Method; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D007275:Injections, Intravenous; D007431:Intraoperative Complications / Q000097:blood / Q000517:prevention & control; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D012083:Renin / Q000097:blood; D014667:Vasopressins / Q000097:blood
D000959:Antihypertensive Agents; D014667:Vasopressins; D008278:Magnesium Sulfate; D012083:Renin; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine