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硫酸镁输注对小儿腺样体切除术/扁桃体切除术中的不适或苏醒现象无效。

Magnesium sulphate infusion is not effective on discomfort or emergence phenomenon in paediatric adenoidectomy/tonsillectomy.

作者信息

Apan Alparslan, Aykaç Esra, Kazkayasi Mustafa, Doganci Nur, Tahran Filiz Datli

机构信息

Kırıkkale University Faculty of Medicine, Department of Anaesthesiology, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2010 Dec;74(12):1367-71. doi: 10.1016/j.ijporl.2010.09.004. Epub 2010 Sep 28.

Abstract

OBJECTIVE

This study was performed to evaluate the possible influence of magnesium sulphate which has sedative and analgesic properties on sevoflurane-induced emergence agitation in paediatric patients undergoing adenoidectomy with or without tonsillectomy.

METHODS

One hundred and ten paediatric patients aged between 3 and 16 years were randomly allocated to the study. Propofol 2-2.5 mg kg(-1), vecuronium 0.1 mg kg(-1) and fentanyl 1 μg kg(-1) were used for induction of anesthesia and sevoflurane at 1 MAC with nitrous oxide in oxygen (35%) mixture was administered as maintenance. Magnesium sulfate 30 mg kg(-1) in saline (20 mL) in the Group M, or equal volume of saline for controls (Group C) was started 10 min before and infused until the end of the operation. Recovery characteristics included time to extubation, eyes open, emergence and interaction. Patients were evaluated using Modified Aldrete Score (MAS), Pain/Discomfort Scale and Agitation Score. Side effects were determined during emergence and in the recovery.

RESULTS

Time to open eyes was significantly higher in the magnesium treatment group (GroupC: 7.7±3.5, Group M: 12.7±17.5 min, p=0.001). Agitation score was significantly lower in Group M at the 60th min (Group C: 1.3±0.7, Group M: 1.0±0.3, p=0.005). Agitation or pain/discomfort scores in the resting observation periods were the same. The initial MAS value was lower in Group M (Group C: 5.0±1.9, Group M: 4.0±1.7, p=0.003). There was no significant difference between groups regarding side effects.

CONCLUSION

Magnesium sulphate infusion has no influence on sevoflurane-induced discomfort or emergence agitation.

摘要

目的

本研究旨在评估具有镇静和镇痛特性的硫酸镁对接受或未接受扁桃体切除术的腺样体切除术小儿患者七氟醚诱导的苏醒期躁动的可能影响。

方法

110例年龄在3至16岁的小儿患者被随机分配至本研究。丙泊酚2 - 2.5 mg·kg⁻¹、维库溴铵0.1 mg·kg⁻¹和芬太尼1 μg·kg⁻¹用于麻醉诱导,并以七氟醚1 MAC与氧化亚氮在氧气(35%)混合气体中进行维持麻醉。M组给予硫酸镁30 mg·kg⁻¹溶于20 mL生理盐水,对照组(C组)给予等体积生理盐水,均在手术前10分钟开始输注并持续至手术结束。恢复特征包括拔管时间、睁眼时间、苏醒时间和相互作用。使用改良Aldrete评分(MAS)、疼痛/不适量表和躁动评分对患者进行评估。在苏醒期和恢复过程中确定副作用。

结果

镁治疗组的睁眼时间显著更长(C组:7.7±3.5,M组:12.7±17.5分钟,p = 0.001)。M组在第60分钟时的躁动评分显著更低(C组:1.3±0.7,M组:1.0±0.3,p = 0.005)。静息观察期的躁动或疼痛/不适评分相同。M组的初始MAS值更低(C组:5.0±1.9,M组:4.0±1.7,p = 0.003)。两组在副作用方面无显著差异。

结论

输注硫酸镁对七氟醚诱导的不适或苏醒期躁动无影响。

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