Ray Manjushree, Bhattacharjee Dhurjoti Prosad, Hajra Bimal, Pal Rita, Chatterjee Nilay
Department of Anaesthesiology, N.R.S. Medical College, Kolkata, India.
Indian J Anaesth. 2010 Mar;54(2):137-41. doi: 10.4103/0019-5049.63659.
This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy five patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 mug/kg as a bolus before induction and 1mug/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS) to reach 60 was significantly lower in Group C and Group M (P < 0.0001). Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001). Postoperative recovery was slower in Group M compared with other two groups (P < 0.001). Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.
这项随机、安慰剂对照、双盲研究旨在评估静脉注射可乐定和硫酸镁对术中血流动力学、麻醉药物用量及术后恢复的影响。75例行择期上肢骨科手术的患者被随机分为三组。C组在诱导前静脉推注可乐定3μg/kg,术中以1μg/(kg·小时)的速度持续输注;M组在诱导前静脉推注硫酸镁30mg/kg,术中以10mg/(kg·小时)的速度持续输注;P组输注相同体积的等渗盐水。麻醉诱导和维持采用枸橼酸芬太尼和丙泊酚,维库溴铵维持肌肉松弛。记录诱导时间、恢复时间以及丙泊酚和枸橼酸芬太尼的用量。可乐定和硫酸镁均可使麻醉诱导迅速。C组和M组双谱指数(BIS)降至60的时间显著缩短(P<0.0001)。C组和M组丙泊酚和芬太尼的用量显著减少(P<0.001)。与其他两组相比,M组术后恢复较慢(P<0.001)。围手术期使用可乐定和硫酸镁均可显著减少丙泊酚和枸橼酸芬太尼的用量。硫酸镁导致恢复延迟。