Impact of Early-Stage IV Mineral Supplementation on Discomfort Following Minimally Invasive Gallbladder Surgery

Abstract

Magnesium sulfate, an N-methyl-D-aspartate (NMDA) receptor antagonist, is known for its potential analgesic effects in perioperative settings. This study aimed to assess whether administering low-dose intravenous magnesium sulfate before surgical incision could influence the intensity of early postoperative discomfort in patients undergoing minimally invasive gallbladder removal. In a prospective, randomized design, 60 patients classified as ASA I–II scheduled for elective laparoscopic procedures were divided into three equal groups (n=20 each). After the induction of anesthesia and prior to surgical incision, participants received either 5.0 mg/kg magnesium sulfate (group A), 7.5 mg/kg magnesium sulfate (group B), or normal saline as a control (group C).

All groups underwent standardized general anesthesia protocols. Post-surgical pain was assessed at rest using a 0–10 visual analog scale (VAS) at 1, 3, 6, 9, and 24 hours postoperatively. Pain management was administered based on VAS intensity: metamizole for mild pain (VAS 3–4), diclofenac for moderate pain (VAS 5–7), and tramadol for severe pain (VAS 8–10). Results at 1 hour post-surgery showed a significant reduction in pain in both magnesium groups compared to control (Group A: 4.7±1.7; Group B: 3.2±1.8; Group C: 5.2±2.0; p<0.05). At 3 hours, Group B showed notably lower pain scores than Groups A and C (2.4±1.5 vs. 3.7±1.8 and 3.8±2.3 respectively; p<0.05). However, from 6 hours onward, no significant differences in VAS scores were observed among the groups.

In summary, administering magnesium sulfate intravenously at 5.0 or 7.5 mg/kg prior to surgery provided meaningful early postoperative pain relief, with the higher dose yielding superior results during the initial hours. Pain levels after 6 hours were unaffected, and no adverse reactions were recorded during the study period.