Intraperitoneal dexamethasone vs dexamethasone plus magnesium sulphate for pain relief in laparoscopic cholecystectomy / Abdelkhalik Mahmoud Samy Shaban ; Supervised Hala Ezzat Abdelnaim , Nashwa Nabil Talaat , Mona Hamed Elsherbiny

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Laparoscopic cholecystectomy has become a standard technique for gall bladder surgery. Benefits in comparison to conventional laparotomy are shorter lived effects on pulmonary function and less postoperative pain. (1,2) However, patients often suffer from considerable pain during the first 24 postoperative hours. Pain can prolong hospital stay and lead to increased morbidity. Several investigations have been conducted in order to find the cause of this pain. According to some of these investigations, the pain is attributed to peritoneal inflammation due to carbon dioxide pneumoperitoneum. (7,8) Since steroids have been used for reducing inflammation, they may be considered as alternatives for relieving pain. Dexamethasone is a strong long acting glucocorticoid and it is widely used after surgery. It has been established that steroids are effective in relieving postoperative pain in laparoscopic cholecystectomy. (9,10) Also, administration of magnesium sulphate has been shown to have a potential to prevent postoperative pain and to reduce intra operative anesthetic and analgesic requirements being an antagonist of N-methyl-D-aspartate (NMDA) receptors and its associated ion channels

Issued also as CD