Ozalevli M, Cetin T O, Unlugenc H, Guler T, Isik G
Department of Anaesthesiology, Faculty of Medicine, Cukurova University, Adana, Turkey.
Acta Anaesthesiol Scand. 2005 Nov;49(10):1514-9. doi: 10.1111/j.1399-6576.2005.00793.x.
The addition of intrathecal (IT) magnesium to spinal fentanyl prolongs the duration of spinal analgesia for vaginal delivery. In this prospective, randomized, double-blind, controlled study, we investigated the effect of adding IT magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia.
One hundred and two ASA I or II adult patients undergoing lower extremity surgery were recruited. They were randomly allocated to receive 1.0 ml of preservative-free 0.9% sodium chloride (group S) or 50 mg of magnesium sulphate 5% (1.0 ml) (group M) following 10 mg of bupivacaine 0.5% plus 25 microg of fentanyl intrathecally. We recorded the following: onset and duration of sensory block, the highest level of sensory block, the time to reach the highest dermatomal level of sensory block and to complete motor block recovery and the duration of spinal anaesthesia.
Magnesium caused a delay in the onset of both sensory and motor blockade. The highest level of sensory block was significantly lower in group M than in group S at 5, 10 and 15 min (P < 0.001). The median time to reach the highest dermatomal level of sensory block was 17 min in group M and 13 min in group S (P < 0.05). The mean degree of motor block was also lower in group M at 5, 10 and 15 min (P < 0.001). The median duration of spinal anaesthesia was longer in group M (P < 0.001).
In patients undergoing lower extremity surgery, the addition of IT magnesium sulphate (50 mg) to spinal anaesthesia induced by bupivacaine and fentanyl significantly delayed the onset of both sensory and motor blockade, but also prolonged the period of anaesthesia without additional side-effects.
鞘内注射镁剂与脊髓芬太尼联合应用可延长阴道分娩脊髓镇痛的持续时间。在这项前瞻性、随机、双盲、对照研究中，我们调查了鞘内注射硫酸镁对布比卡因-芬太尼脊髓麻醉的影响。
招募了102例接受下肢手术的ASA I或II级成年患者。在鞘内注射0.5%布比卡因10mg加25μg芬太尼后，他们被随机分配接受1.0ml无防腐剂的0.9%氯化钠溶液（S组）或5%硫酸镁50mg（1.0ml）（M组）。我们记录了以下指标：感觉阻滞的起效时间和持续时间、感觉阻滞的最高平面、达到感觉阻滞最高皮节平面的时间、运动阻滞恢复完成的时间以及脊髓麻醉的持续时间。
镁剂导致感觉和运动阻滞的起效延迟。在5、10和15分钟时，M组感觉阻滞的最高平面显著低于S组（P<0.001）。M组达到感觉阻滞最高皮节平面的中位时间为17分钟，S组为13分钟（P<0.05）。在5、10和15分钟时，M组的平均运动阻滞程度也较低（P<0.001）。M组脊髓麻醉的中位持续时间更长（P<0.001）。
在接受下肢手术的患者中，鞘内注射硫酸镁（50mg）至布比卡因和芬太尼诱导的脊髓麻醉中，显著延迟了感觉和运动阻滞的起效，但也延长了麻醉时间且无额外副作用。
