Investigation of the effects of perioperative magnesium infusion on anesthesia depth, postoperative analgesia parameters, stress response, recovery, shivering, and blood magnesium levels in laparoscopic minimally invasive gynecological surgeries

Laparoscopic minimally invasive surgeries are preferred due to their low complication rates, short hospitalization periods, and rapid recovery advantages. However, surgical stress response, postoperative pain, and anesthesia-related complications can negatively impact patient comfort and the recovery process. This prospective observational study evaluated 92 patients who underwent elective laparoscopic minimally invasive surgery at Suleyman Demirel University Hospital between September and December 2024. Patients were divided into two groups: those receiving magnesium infusion (Group M, n=46) and a control group without magnesium (Group S, n=46). The groups were similar in terms of age, gender, ASA scores, and comorbidity distribution. There was no statistically significant difference in terms of operative types and durations. Perioperative vital parameters revealed that blood pressure stability was better maintained in the magnesium group. Entropy values measured at the 30th minute post-incision showed significantly lower state entropy (SE) and response entropy (RE) values in the magnesium group compared to the control group (p<0.05). VAS scores at 0 and 24 hours showed significant differences (p<0.05), indicating better pain control in the magnesium group. Although recovery times were shorter and the incidence of shivering was lower in the magnesium group, the differences were not statistically significant. There was no significant difference in blood glucose levels. No significant differences were found in CRP and cortisol levels on postoperative day 1 (p<0.05). Postoperative recovery assessed by the Quality of Recovery-15 (QoR-15) score was significantly higher in the magnesium group (135 ± 5) compared to the control group (117 ± 6) (p<0.01). In conclusion, perioperative magnesium sulfate infusion appears to enhance postoperative pain control and suppress the surgical stress response; however, further studies with larger patient cohorts are needed.