Influence of magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy A meta-analysis of randomized controlled studies

Background: The impact of magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of magnesium sulfate on hemodynamic responses for laparoscopic cholecystectomy. Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2018 for randomized controlled trials (RCTs) assessing the effect of magnesium sulfate on hemodynamic responses for laparoscopic cholecystectomy. Meta-analysis is performed using the random-effect model. Results: Four RCTs involving 208 patients are included in the meta-analysis. Overall, compared with control group in laparoscopic cholecystectomy, intravenous magnesium sulfate is associated with systolic blood pressure at 30minutes [Std. MD=-1.34; 95% confidence interval (95% CI)=-1.86 to -0.82; P<.00001], diastolic blood pressure at 30minutes (Std. MD=-1.40; 95% CI=-1.86 to -0.94; P<.00001), mean arterial pressure at 30 minutes (Std. MD=-1.19; 95% CI=-1.91 to -0.46; P=.001), systolic blood pressure at 10minutes (Std. MD=-1.61; 95% CI=-2.08 to -1.13; P<.00001), diastolic blood pressure at 10minutes (Std. MD=-1.54; 95% CI=-2.68 to -0.40; P=.008), heart rate at 30minutes (Std. MD=-2.09; 95% CI=-2.87 to -1.32; P<.00001), but results in prolonged extubation time (Std. MD=0.96; 95% CI=0.18-1.74; P=.02). Conclusion: Magnesium sulfate can reduce blood pressure, but with the increase in extubation time for laparoscopic cholecystectomy.