Tramèr Martin R, Glynn Chris J
Division of Anesthesiology, Department Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland.
Anesth Analg. 2007 Jun;104(6):1374-9, table of contents. doi: 10.1213/01.ane.0000263416.14948.dc.
Previous studies have suggested that magnesium may be a useful adjuvant to postoperative analgesia.
We randomized adults undergoing ambulatory ilioinguinal hernia repair or varicose vein operation under general anesthesia (propofol, fentanyl, isoflurane-N2O) to receive magnesium sulfate 4 g IV or physiological saline after induction. All patients preoperatively received diclofenac 100 mg rectally and those undergoing hernia repair had a postoperative ilioinguinal-iliohypogastric nerve block done. Pain, analgesic consumption, and adverse effects were recorded in the recovery room and, using a questionnaire, up to 3 days postoperatively.
We randomized 200 patients (101 magnesium, 99 placebo). There were no differences in hemodynamic variables before and immediately after study drug injection. Pain intensity at rest and on movement after 1, 2, and 4 h, time to first rescue analgesic, and cumulative numbers of non-opioid and opioid analgesics were similar among groups. There was no difference in the incidence of postoperative nausea and vomiting, dizziness, headache, or fainting. The incidence of postoperative shivering was significantly lower in the magnesium group (4% vs 13.1%, P = 0.0232). Adequately completed questionnaires were returned by 84 placebo and 82 magnesium patients. There was no difference between groups for any of the analyzed outcomes during the first three postoperative days, neither for patients undergoing inguinal hernia repair nor for those undergoing varicose vein stripping.
In patients undergoing ambulatory ilioinguinal hernia repair or varicose vein operations under general anesthesia supplemented with other analgesic adjuvants, pretreatment with IV magnesium sulfate 4 g has no impact on postoperative pain and analgesic consumption.
先前的研究表明，镁可能是术后镇痛的一种有用辅助药物。
我们将在全身麻醉（丙泊酚、芬太尼、异氟烷 - 氧化亚氮）下接受门诊髂腹股沟疝修补术或静脉曲张手术的成年人随机分组，诱导后分别静脉注射4克硫酸镁或生理盐水。所有患者术前均经直肠给予双氯芬酸100毫克，接受疝修补术的患者术后进行髂腹股沟 - 髂腹下神经阻滞。在恢复室记录疼痛、镇痛药物用量和不良反应，并使用问卷在术后长达3天内进行记录。
我们随机分配了200名患者（101名使用镁，99名使用安慰剂）。研究药物注射前和注射后即刻的血流动力学变量无差异。各组在1、2和4小时后的静息和活动时疼痛强度、首次使用补救性镇痛药的时间以及非阿片类和阿片类镇痛药的累积用量相似。术后恶心呕吐、头晕、头痛或昏厥的发生率无差异。镁组术后寒战的发生率显著更低（4% 对13.1%，P = 0.0232）。84名使用安慰剂的患者和82名使用镁的患者充分完成了问卷。在术后的前三天，无论是接受腹股沟疝修补术的患者还是接受静脉曲张剥脱术的患者，任何分析的结果在组间均无差异。
在接受全身麻醉并辅以其他镇痛辅助药物的门诊髂腹股沟疝修补术或静脉曲张手术患者中，静脉注射4克硫酸镁预处理对术后疼痛和镇痛药物用量无影响。
