الفهرس 
Physiology and Pharmacology Magnesium SulfateOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: Bariatric surgery is effective in reducing obesity related co -morbidities as well as achieving major long-term weight loss and improvement in quality of life. Opioids given intra-operatively as well as post operatively could play a significant part in postoperative pulmonary morbidity.
Objective: The aim of this study is to evaluate the efficacy and safety of giving general anesthesia without the use of any opioids in bariatric surgery.
Methods: This randomized, clinical study enrolled 60 patients with BMI > 45 kg/m2 who were scheduled for elective laparoscopic bariatric surgery at Ain Shams university educational hospital, patients were randomly allocated in a 1:1 ratio into 1 of 2 groups: The non opioid group (n group) patients received propofol 2 mg/Kg, analgesic dose of ketamine 0.25 mg/Kg, dexmedetomidine 0.5 to 1 ug/kg IBW, Mg sulphate 40 mg/kg IBW and lidocaine 1.5 mg/kg IBW, and the opioid group (o group) patients received propofol 2 mg/Kg and analgesic dose of fentanyl 2‑5 mcg/Kg. Hemodynamics in the form of “heart rate, systolic, diastolic, and mean arterial blood pressure,SpO2,etCO2, peak inspiratory pressure”were recorded on induction and ½ hourly thereafter. Pain monitoring through visual analog scale (VAS) 30 min after recovery, hourly for 2 h and every 4 h for 24 h was also recorded.
Results: There were no statistically significant differences in both groups as regard heart rate, mean blood pressure, etCO2, peak inspiratory pressure. But postoperative oxygen saturation was higher and pain score was lower in the non opioid group.
Conclusion: We found that non-opioid drugs combination (Dexamedetomidine, lidocaine, ketamine, and magnesium sulfate) produced adequate anesthesia and analgesia compared to opioids (fentanyl) during bariatric surgeries. In the post anesthesia care unit, non-opioid treated patients were less sedated, with less respiratory depression, hypoxemia, required less analgesia and had less pain scores compared to fentanyl anesthetized patients.
Key words: Bariatric anesthesia, ketamine anesthesia, dexmedetomidine, lidocaine, propofol.