Gunduz Aytac, Bilir Ayten, Gulec Sacit
Department of Anaesthesia, Bandýrma Hospital, Bandýrma, Turkey.
Reg Anesth Pain Med. 2006 May-Jun;31(3):233-6. doi: 10.1016/j.rapm.2006.03.001.
The aim of this study was to evaluate the effect of the addition of magnesium to prilocaine on the duration of sensory and motor-nerve block.
After institutional approval, 60 ASA physical status I and II patients, between 18 and 60 years of age and scheduled for forearm and hand surgery under axillary brachial plexus block, were included in the study. Patients were randomly assigned to 1 of 4 groups. All of the patients received 5 mg/kg of 2% prilocaine and isotonic sodium chloride solution in 35 mL total volume for axillary brachial plexus block. Group I received intravenous saline, and group II received 150 mg intravenous magnesium at the same time as local anesthetic administration. In group III, 100 mg of magnesium, and in group IV, 150 mg of magnesium, were added to local anesthetic solution. Sensory block and motor block of musculocutaneous, radial, median, and ulnar nerves were recorded at 5-minute intervals.
The duration of motor block was significantly longer in group IV than in other groups (167 +/- 30, 177 +/- 17, 180 +/- 20, and 250 +/- 19 minutes in groups I to IV, respectively) (P < .01). Mean duration of sensory block in both of the perineural magnesium groups was statistically different than in groups I and II (P < .001). Duration of sensory block in group IV (304 +/- 30 minutes) was significantly longer than in group III (253 +/- 23 minutes) (P < .001).
The admixture of magnesium to prilocaine for axillary brachial plexus block provided a pronounced prolongation of sensory and motor block without side effects.
本研究旨在评估在丙胺卡因中添加镁对感觉和运动神经阻滞持续时间的影响。
经机构批准,纳入60例年龄在18至60岁之间、美国麻醉医师协会(ASA)身体状况分级为I级和II级、计划在腋路臂丛阻滞下进行前臂和手部手术的患者。患者被随机分为4组中的1组。所有患者均接受5mg/kg的2%丙胺卡因和等渗氯化钠溶液,总体积为35mL用于腋路臂丛阻滞。I组静脉注射生理盐水,II组在给予局部麻醉药的同时静脉注射150mg镁。III组在局部麻醉药溶液中添加100mg镁,IV组在局部麻醉药溶液中添加150mg镁。每隔5分钟记录肌皮神经、桡神经、正中神经和尺神经的感觉阻滞和运动阻滞情况。
IV组的运动阻滞持续时间显著长于其他组(I至IV组分别为167±30、177±17、180±20和250±19分钟)(P<.01)。两个神经周围注射镁的组的感觉阻滞平均持续时间与I组和II组在统计学上有差异(P<.001)。IV组的感觉阻滞持续时间(304±30分钟)显著长于III组(253±23分钟)(P<.001)。
在丙胺卡因中添加镁用于腋路臂丛阻滞可显著延长感觉和运动阻滞时间且无副作用。