Efficacy of esmolol versus magnesium sulphate on quality of recovery in patients undergoing laparoscopic cholecystectomy: Randomized controlled study

Abstract

Background: Ambulatory procedures have a universal objective of rapid, efficient and secure recovery and release. Preliminary advances utilizing intraoperative esmolol infusion have registered a postoperative opioid saving outcomes. In the current study, we compared intraoperative esmolol versus magnesium sulphate infusions on postoperative recovery profile and stay in the postanaesthesia care unit (PACU). Patients and methods: Sixty patients, of both sexes, of ASA I or II planned for ambulatory laparoscopic cholecystectomy under general anaesthesia were engaged into two groups. Esmolol group was given loading dose (1 mg/kg) over a period of 10 minutes followed by (30 μg/kg/min) all through the surgery, whereas magnesium sulphate (MgSo4) group was given loading dose (40 mg/kg) over 10 minutes then maintenance dose (15 mg/kg/h) till end of surgery. General anaesthesia and postoperative analgesia were standardized for all patients. Variables denoting immediate recovery from anaesthesia, pain score and time for first call to analgesia were recorded. White-Song score ≥ 12 were employed as a tool to review the rapidity of recovery. Results: Compared to MgSo4 group, the esmolol group exhibited statistically significant shorter times for sponteaous eye opening, tongue extension, extubation and patients’ capability to recall their names. Incidence of vomiting as well as the total amount of ondansetron consumed in the PACU were evidently less among the esmolol group, whereas pain scores and the time of recall for first rescue analgesia did not vary significantly among the two studied groups. Members of the esmolol group displayed significant higher White -Song score at all times of measurements except at 120 minutes compared to those of MgSo4 group. Conclusions: Perioperative esmolol infusion is accompanied by superior and fast-tracked recovery profile compared to MgSo4 infusion.