Postoperative nausea and vomiting is a common adverse effect after sleeve gastrectomy, mostly due to increased intragastric pressure. The present trial aimed to assess the effect of pyloric injection of mixture of magnesium sulfate and lidocaine on postoperative gastric intraluminal pressure and incidence of nausea and vomiting.

Inclusion Criteria:

• Patients that aged between18 and 65 years.
• American Society of Anesthesiologists (ASA) class I - III.
• Morbidly-obese patients who failed to achieve and maintain a clinically significant weight loss through supervised non-surgical methods for at least 6 months.
• Surgery was conducted as the first line of treatment in case of patients with BMI ≥ 50 kg/m2 (super obese).

Exclusion Criteria:

• Obesity secondary to endocrine disorders.
• History of any previous bariatric procedure.
• Impaired intellectual capacity or major psyciatric disorder.
• Sweet eaters who would not adopt a change of postoperative eating habits.
• Lack of willingness and motivation to embrace postoperative lifestyle changes.
• Substance abuse.
• Pregnancy or expected pregnancy in the following 12 to 18 months.
• Severe gastroesophageal reflux disease