Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Can J Anaesth. 2012 Jan;59(1):21-7. doi: 10.1007/s12630-011-9604-5. Epub 2011 Oct 20.
Local anesthetic adjuvants have been studied previously in an attempt to prolong the duration of analgesia after peripheral nerve blockade. Magnesium has been shown to have an antinociceptive effect in animal and human pain models. We evaluated the effects of adding magnesium sulphate to long-acting local anesthetics for interscalene nerve block to prolong the duration of analgesia and improve the analgesic quality.
We enrolled 66 patients undergoing arthroscopic rotator cuff repair. The interscalene nerve block was performed with 0.5% bupivacaine 20 mL with epinephrine (1:200,000) plus either 10% magnesium sulphate 2 mL (Magnesium Group) or normal saline 2 mL (Saline Group). The following data were recorded for 24 hr after surgery: onset times and durations of sensory and motor blocks, analgesic duration, the pain numeric rating scale (NRS), postoperative fentanyl consumption, and complications.
The duration of analgesia was longer in the Magnesium Group than in the Saline Group [mean and (standard deviation) 664 (188) min vs 553 (155) min, respectively; P = 0.017]. Patients in the Magnesium Group had significantly reduced pain NRS scores at 12 hr (P = 0.012), but the cumulative fentanyl consumption was similar in both groups. The onset times and durations of sensory and motor blocks were not significantly different between the two groups.
The addition of magnesium sulphate to a bupivacaine-epinephrine mixture for interscalene nerve block prolongs the duration of analgesia and reduces postoperative pain.
局部麻醉剂佐剂已被研究用于延长周围神经阻滞后的镇痛持续时间。镁已被证明在动物和人类疼痛模型中具有镇痛作用。我们评估了在长效局部麻醉剂中加入硫酸镁对延长镇痛持续时间和改善镇痛质量的影响。
我们纳入了 66 例行关节镜肩袖修复的患者。使用 0.5%布比卡因 20 mL 加肾上腺素（1:200,000）加 10%硫酸镁 2 mL（硫酸镁组）或生理盐水 2 mL（盐水组）进行肌间沟神经阻滞。记录术后 24 小时内的以下数据：感觉和运动阻滞的起效时间和持续时间、镇痛持续时间、疼痛数字评分量表（NRS）评分、术后芬太尼用量和并发症。
硫酸镁组的镇痛持续时间长于盐水组[分别为 664（188）分钟和 553（155）分钟；P=0.017]。硫酸镁组在 12 小时时疼痛 NRS 评分显著降低（P=0.012），但两组芬太尼累积用量相似。两组的感觉和运动阻滞的起效时间和持续时间无显著差异。
在布比卡因-肾上腺素混合物中加入硫酸镁可延长肌间沟神经阻滞的镇痛持续时间并减轻术后疼痛。
