Perioperative pulmonary function in laparoscopic cholecystectomy versus open cholecystectomy, with preemptive intercostal nerve block

Background: the purpose of this study was to assess the efficacy of open cholecystectomy with right intercostal nerve block as an equivalent or substitute to laparoscopic cholecystectomy as regarding to the effect on the postoperative pulmonary function

Methods: forty female patients included in the study, were allocated randomly into two groups [20 patients in each] group [I] undergone laparoscopic cholecystectomy, while group [II] was subjected for open cholecystectomy with preemptive right intercostal nerve block. VC, FVC, FEVI, PEFR, and ABG were assessed

Results: all measured parameters of pulmonary function were markedly depressed early postoperative with some improvements noticed 4 hours later but still far from the preoperative values. These reductions in pulmonary function were less marked in open cholecystectomy with intercostals nerve block [II] than in laparoscopic cholecystectomy [I]. The operative time and total required dose of meperidine were significantly lower in group [II] than group [I]. There were no changes in AGS between groups or within the same group

Conclusion: open cholecystectomy with preemptive light intercostal nerve block can be less deterious or at least equivalent to laparoscopic cholecystectomy as regards the effect on postoperative pulmonary function and the total 24 hour requirement of meperidine

role of magnesium sulphate as an adjuvant to propofol sedation in ICU patients, a comparative study

The aim of this study was to determine the effect of the concomitant use of magnesium sulphate infusion together with propofol continuous infusion used for sedation of the ICU patients on the total propofol consumption and on the patients' hemodynamics. Thirty mechanically ventilated ICU patients were randomly divided into two equal groups and allocated to receive either magnesium sulphate or placebo together with profolol continuous infusion. Hemodynamic monitoring included heart rate and invasive blood pressure measurements. Biochemical parameters included serum Na+, K+, Ca++. Mg++, total bilirubin and creatinine, and finally total propofol consumption in 24 hours. The use of magnesium sulphate continuous infusion significantly reduced total propofol consumption in group 2 [p<0.05]. This reduction was observed correlating with significant progressive rise of serum Mg++ [p<0.05]. No significant differences were detected in patients' hemodynamics or other biochemical parameters between both groups after the use of magnesium sulphate. The results indicate that the concomitant use of magnesium sulphate with propofol continuous sedation in ICU patients significantly reduced total propofol consumption with no significant derangements of the patients' hemodynamics or chemistry