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硫酸镁在开胸手术患者术后疼痛管理中的作用。

Role of magnesium sulfate in postoperative pain management for patients undergoing thoracotomy.

作者信息

Ozcan Perihan Ergin, Tugrul Simru, Senturk N Mert, Uludag Elvan, Cakar Nahit, Telci Lutfi, Esen Figen

机构信息

Department of Anesthesiology and Intensive Care, Istanbul University, Istanbul, Turkey.

出版信息

J Cardiothorac Vasc Anesth. 2007 Dec;21(6):827-31. doi: 10.1053/j.jvca.2006.11.013. Epub 2007 Feb 7.

Abstract

OBJECTIVE

The purpose of this study was to investigate the effect of magnesium sulfate on pain management for post-thoracotomy patients.

DESIGN

A prospective, randomized, controlled clinical study.

SETTING

University hospital.

PARTICIPANTS

Twenty-four patients undergoing thoracotomy.

INTERVENTIONS

After thoracotomy operations, patients were assigned to 2 groups. The control group received intravenous morphine (0.5 mg/h infusion, 0.3 mg patient-controlled anesthesia dose, 15-minute lockout time) via patient-controlled analgesia, and the magnesium group received magnesium sulfate (30-mg/kg bolus, 10 mg/kg/h infusion for 48 hours) plus the same patient-controlled analgesia protocol.

MEASUREMENTS AND MAIN RESULTS

Visual analog scale for pain score, sedation score, mean arterial pressure, heart rate, and valid and invalid analgesic demand were recorded. Serum magnesium levels were determined at postanesthesia care unit admission, at 24 hours, and at 48 hours. Side effects were also recorded. There were no significant differences between groups with respect to demographics, sedation score, and pain score. Cumulative mean morphine consumption was found to be higher in the control group compared with the magnesium group at 4, 8, and 48 hours (5.6 +/- 1 mg v 3.2 +/- 0.6 mg [p < 0.0001], 10.2 +/- 1.8 mg v 7.2 +/- 1.6 mg [p = 0.0003), and 40.2 +/- 4.5 mg v 34.8 +/- 6.3 mg [p = 0.02], respectively).

CONCLUSION

Postoperative use of magnesium sulfate reduced opioid consumption for pain after thoracotomy operations.

摘要

目的

本研究旨在探讨硫酸镁对开胸术后患者疼痛管理的影响。

设计

一项前瞻性、随机、对照临床研究。

地点

大学医院。

参与者

24例行开胸手术的患者。

干预措施

开胸手术后,患者被分为两组。对照组通过患者自控镇痛接受静脉注射吗啡(输注速度0.5mg/h,患者自控麻醉剂量0.3mg,锁定时间15分钟),硫酸镁组接受硫酸镁(负荷剂量30mg/kg,输注速度10mg/kg/h,持续48小时)加相同的患者自控镇痛方案。

测量指标及主要结果

记录疼痛视觉模拟评分、镇静评分、平均动脉压、心率以及有效和无效镇痛需求。在麻醉后护理单元入院时、24小时及48小时测定血清镁水平。同时记录副作用。两组在人口统计学、镇静评分和疼痛评分方面无显著差异。发现对照组在4小时、8小时和48小时的吗啡累积平均消耗量高于硫酸镁组(分别为5.6±1mg对3.2±0.6mg [p<0.0001],10.2±1.8mg对7.2±1.6mg [p = 0.0003],40.2±4.5mg对34.8±6.3mg [p = 0.02])。

结论

开胸术后使用硫酸镁可减少疼痛的阿片类药物消耗量。

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