الفهرس 
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Abstract
This prospective, double-blind, randomized study was carried out at the department of anesthesia and intensive care unit in El-Minia University Hospital during the period from January 2016 to January 2017 on a total 99 patients of either sex (ASA) physical status I and II who undergo elective laparoscopic cholecystectomy surgery after institutional approval and informed consents obtained from all patients prior to performing the study.
This study aimed to evaluate and compare the use of intra-peritoneal administration of 200 mg lidocaine 2% alone or with either 30 mg /kg magnesium sulfate or 20 mg tenoxicam.
Patients enrolled into the study were divided into 3 equal groups of 33 patients in each group:-
1- group I (control) C : received 200 mg lidocaine 2%
2- group II (magnesium sulfate) M : received 200 mg lidocaine 2% plus 30 mg /kg magnesium sulfate
3- group III (tenoxicam) T : received 200 mg lidocaine 2% plus 20 mg tenoxicam
All the previous medications were administered of 100 ml by addition of 0.9% normal saline and supplied in coded syringe in a double blind fashion to be instilled intra-peritoneal after gall bladder removal.
All patients were anesthetized by general anesthesia. The three groups were compared as regard demographic data (age, sex, weight, surgical and anesthesia time), hemodynamics (HR, systolic, diastolic, and MAP) pre-operatively, 5, 10 min. intra-operatively, before drug administration, immediately after recovery 10, 30, 60 min. and at 2, 4, 8, 12, 18, 24 hrs after recovery, post-operative pain by visual analogue pain score (VAPS) immediately after full recovery and at 1, 2, 4, 8, 12, 18 and 24 hrs post-operatively, time to first analgesic request and total post-operative 24 hrs analgesic consumption, incidence of nausea and vomiting at intervals 0-4 hrs, 4-8 hrs, 8-12 hrs and 12-24 hrs after the surgery and occurrence of any adverse effects.
The results of this research revealed that the three groups were comparable as regard the demographic data. However there was significant difference in hemodynamics (HR, systolic, diastolic, and MAP) immediately after recovery, 10, 30, 60 min. and 2 hrs after recovery with more steady values detected in magnesium sulfate group followed by tenoxicam group and lastly lidocaine group.
Earlier and better control of postoperative pain was recorded in magnesium sulfate group then tenoxicam group when compared to lidocaine group alone immediately after recovery and at 1, 2, 4 hrs after full recovery reflected by a statistically significant lower visual analogue pain score (VAPS), longer time of first analgesic request and decrease the total postoperative analgesic requirement.
Also this research recorded less incidence of nausea and vomiting , lower (VAS) of them with lower consumption of antiemetics in the early postoperative period (0-4) hrs in magnesium sulfate group followed by tenoxicam group when compared to lidocaine group.