Atropine [HSA-Biotin]

Background: Laparoscopic cholecystectomy is a commonly performed surgical procedure. In comparison to open cholecystectomy, there is less post-operative pain, less respiratory complications, early recovery and shorter hospital stay. In spite of all these advantages, laparoscopic cholecystectomy can have a few hemodynamic adverse effects during surgery. Carbon dioxide is used to create Pneumoperitoneum during laparoscopic surgery that can cause increase in arterial blood pressure, heart rate, and peripheral vascular resistance. Aim: To compare the efficacy of MgSO4 versus placebo in controlling the rise in arterial blood pressure during laparoscopic cholecystectomy after creation of CO2 pneumoperitoneum. Methods: This was a randomized controlled trial conducted in department of Anesthesia, Mayo Hospital, Lahore. Total 180 patients were included in the study and randomly divided in to two groups. Each group contained 90 patients. Immediately before creation of Carbon dioxide pneumoperitoneum, the placebo group (C-Group) received N/S 0.5ml/kg and Magnesium sulphate group (MS-Group) received 0.5ml/kg of 10% MgSO4 (50mg/kg) over 2-3 mins. CO2 pneumoperitoneum was maintained at pressure of 14mmHg. At completion of surgery, the patients were given reversal (Neostigmine 0.05mg/kg, and Atropine 0.014mg/kg) after adequate respiratory rate and tidal volume has been established. Tracheal extubation was done when patient became fully awake. Oxygen was given via face mask for ten minutes. Systolic arterial pressure and diastolic arterial pressure were noted at following intervals; before creation of PP, at 5,10,20,and 30 mins after creation of PP. Results: The mean age of all patients was 40.08 +/- 8.31 years while mean age of patients in MgSO4 and placebo group was 39.78 +/- 8.14 years and 40.38 +/- 8.15 years respectively. In Magnesium Sulphate group a total of 80(88.9%) cases and in placebo group 32(35.6%) cases had efficacy. The efficacy was significantly higher in MgSO4 group as compared to placebo group, p-value < 0.05. Conclusion: The cases who received I/V Magnesium Sulphate had higher efficacy in terms of blood pressure control after Carbon dioxide pneumoperitoneum when compared to placebo group.