Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
Br J Anaesth. 2010 Jan;104(1):89-93. doi: 10.1093/bja/aep334.
In a randomized, double-blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia on postoperative analgesia and postoperative analgesic requirements.
Forty patients undergoing total hip replacement arthroplasty under spinal anaesthesia were included. After the induction of spinal anaesthesia, the magnesium group (Group M) received magnesium sulphate 50 mg kg(-1) for 15 min and then 15 mg kg(-1) h(-1) by continuous i.v. infusion until the end of surgery. The saline group (Group S) received the same volume of isotonic saline over the same period. After surgery, a patient-controlled analgesia (PCA) device containing morphine and ketorolac was provided for the patients. Postoperative pain scores, PCA consumption, and the incidences of shivering, postoperative nausea, and vomiting were evaluated immediately after surgery, and at 30 min, 4, 24, and 48 h after surgery. Serum magnesium concentrations were checked before the induction of anaesthesia, immediately after surgery, and at 1 and 24 h after surgery.
Postoperative pain scores were significantly lower in Group M at 4, 24, and 48 h after surgery (P<0.05). Cumulative postoperative PCA consumptions were also significantly lower in Group M at 4, 24, and 48 h after surgery (P<0.05). Postoperative magnesium concentrations were higher in Group M (P<0.05 at 4, 24, and 48 h after surgery), but no side-effects associated with hypermagnesemia were observed. Haemodynamic variables and the incidences of shivering, nausea, and vomiting were similar in the two groups.
I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analgesia.
在一项随机、双盲、前瞻性研究中，我们评估了脊髓麻醉期间静脉输注硫酸镁对术后镇痛和术后镇痛需求的影响。
纳入 40 例行脊髓麻醉下全髋关节置换术的患者。脊髓麻醉诱导后，硫酸镁组（M 组）在 15 分钟内输注硫酸镁 50mg/kg，然后以 15mg/kg/h 的速度持续静脉输注至手术结束。生理盐水组（S 组）在同一时期给予等体积的生理盐水。手术后，为患者提供包含吗啡和酮咯酸的患者自控镇痛（PCA）装置。评估术后即刻、术后 30 分钟、4 小时、24 小时和 48 小时的疼痛评分、PCA 用量以及寒战、术后恶心和呕吐的发生率。检测麻醉诱导前、手术后即刻和手术后 1 小时和 24 小时的血清镁浓度。
术后 4 小时、24 小时和 48 小时，M 组的术后疼痛评分明显较低（P<0.05）。术后 4 小时、24 小时和 48 小时，M 组的累积术后 PCA 用量也明显较低（P<0.05）。M 组术后镁浓度较高（术后 4、24 和 48 小时时均 P<0.05），但未观察到与高镁血症相关的不良反应。两组的血流动力学变量以及寒战、恶心和呕吐的发生率相似。
脊髓麻醉期间静脉注射硫酸镁可改善术后镇痛。
