Efficacy of Intravenous Dexamethasone and Magnesium Sulfate Injection on Pain After Laparoscopic Cholecystectomy

Abstract

Postoperative pain is a complex physiological response to tissue damage. Providing effective postoperative analgesia prevents complications and improves patients’ quality of life. The present study aimed to compare the effects of intravenous dexamethasone and magnesium sulfate on pain after laparoscopic cholecystectomy (LC). In this double-blind randomized controlled clinical trial, 60 patients aged 18 to 70 years undergoing laparoscopic cholecystectomy were randomly divided into two groups, (dexamethasone group and magnesium sulfate group) after obtaining written consent. The magnesium sulfate group received 50 mg/kg of magnesium sulfate diluted in 100 mL of 0.9% normal saline after endotracheal intubation for 15 min, and group D received 0.1 mg/kg (up to a maximum of 8 mg) intravenous dexamethasone 15 minutes before anesthesia induction. Pain levels were compared between the two groups based on a Visual Analog Scale (VAS). Pain intensity decreased in both groups, but VAS scores was significantly lower in the dexamethasone group at 1, 2, and 24 hours after surgery. The incidence of complications including chills, itching, and nausea and vomiting was lower in the dexamethasone group, but no statistically significant difference was found. Heart rate and mean arterial pressure decreased in both groups. Hemodynamic stability was significantly higher in the magnesium sulfate group at 1, 2, and 24 hours after surgery. Although magnesium sulfate has fewer effects on patients’ hemodynamics and reduces pain intensity, the administration of dexamethasone has greater and more extensive effects in controlling pain and reducing complications in patients after laparoscopic cholecystectomy.