Effect of intraoperative magnesium infusion Vs. lidocaine infusion on postoperative pain and morphine consumption in patients undergoing laparoscopic cholecystectomy

This randomized, double-blinded, prospective study was aimed to evaluate and compare the analgesic effect of Magnesium and lidocaine on pain, analgesic requirements, quality of sleep and bowel function in patients undergoing laparoscopic cholecystectomy. Seventy five patients were assigned into three groups [n=25 each]. Group M received magnesium sulphate 50 mg kg[-1] as a bolus dose followed by 25 mg Kg[-1] h[-1] Group L received lidocaine 2 mg kg[-1] as a bolus dose followed by 2 mg kg[-1] h[-1] and those of placebo group received saline infusion in an equal manner. These regimens were started 30 minutes before induction of anaesthesia and were discontinued at the end of surgery. Intraoperative fentanyl, cisatracurium and average end tidal sevoflurane were calculated. Pain scores at rest and upon cough and movement were evaluated 1, 2, 6, 12 and 24 h after surgery. Postoperative morphine consumption were recorded at 2 and 24 h. Time to first flatus and insomnia were evaluated after 24 hours. Magnesuim and lidocaine infusions alter anaesthetic dose requirements. Patients in the Magnesim and lidocaine groups had better pain relief and lower opioid consumption than the placebo group [p<0.001]. In addition, lidocaine was associated with earlier return of bowel function and magnesium caused a better quality of sleep [p<0.05]. Both lidocaine and magnesium reduced intraoperative anaesthetic requirements and improved the quality of postoperative analgesia. Moreover, their opioidsaring effect was maintained in the early postoperative period and after 24 hours during the first postoperative day

Painless injection of propofol: pretreatment with ketamine vs thiopental, meperidine, and lidocaine

Propofol, a commonly used anesthetic, often causes pain on injection. Several methods have been described to reduce this pain, however, complete inhibition has not been achieved. Our randomized, placebo controlled, double blind study has been conducted to compare the analgesic efficacy of iv pretreatment of ketamine, meperidine, thiopental, lidocaine to minimize the injection pain of propofol. 125 patients ASA I and II were randomly allocated into 5 groups and received. Group K, ketamine 0.4 mg/kg; Group T, thiopental 0.5 mg/kg; Group M, meperidine 0.4 mg/kg; Group L, lidocaine 1 mg/kg; Group S, saline 3 ml. All pretreatment drugs were made into 4 ml solutions and were accompanied by manual venous occlusion for 1 min, followed by tourniquet release and slowly IV administration of propofol. Pain was assessed with a four point scale. All treatment groups had a significantly lower incidence of pain than placebo group [p < 0.05]. However, it has been observed that pretreatment with ketamine was the most effective in attenuating pain associated with propofol injection [p < 0.05]. For painless injection of propofol, routine pretreatment with ketamine 0.4 mg/kg along with venous occlusion is recommended