Department of Anesthesiology, First Affiliated Hospital, Wenzhou Medical College, Wenzhou, China.
Int J Obstet Anesth. 2012 Oct;21(4):310-6. doi: 10.1016/j.ijoa.2012.05.006. Epub 2012 Aug 2.
Magnesium can potentiate the antinociceptive effect of morphine. This prospective randomized double-blinded study was undertaken to establish the analgesic effect of adding magnesium to epidural morphine during cesarean section.
Two hundred patients undergoing cesarean section under combined spinal-epidural anesthesia were recruited. After administration of intrathecal bupivacaine 10mg, patients were randomly assigned to receive one of four epidural study solutions: 0.1% bupivacaine 10 mL (Group B); 0.1% bupivacaine 10 mL and morphine 1.5mg (Group B+Mor); 0.1% bupivacaine 10 mL and magnesium 500 mg (Group B+Mg); or 0.1% bupivacaine 10 mL morphine 1.5mg and magnesium 500 mg (Group B+Mor+Mg). The primary outcome was the area under the curve for visual analog scale pain scores during 36 h postoperatively. Secondary outcomes included time to the use of rescue analgesics, patient satisfaction and side effects.
Patients in Group B+Mor+Mg had lower for pain scores and area under the curve pain scores both at rest and on movement, increased time for first analgesic request, and increased satisfaction score at 24h after surgery.
Addition of magnesium 500 mg and morphine 1.5mg to epidural 0.1% bupivacaine 10 mL reduced postoperative pain compared with addition of morphine or magnesium alone or no additive.
镁可以增强吗啡的镇痛作用。本前瞻性随机双盲研究旨在确定在剖宫产术中加入镁对硬膜外吗啡的镇痛效果。
招募了 200 名接受蛛网膜下腔-硬膜外联合麻醉的剖宫产患者。在鞘内给予布比卡因 10mg 后，患者被随机分配接受四种硬膜外研究溶液之一：0.1%布比卡因 10mL（B 组）；0.1%布比卡因 10mL 加吗啡 1.5mg（B+Mor 组）；0.1%布比卡因 10mL 和镁 500mg（B+Mg 组）；或 0.1%布比卡因 10mL 吗啡 1.5mg 和镁 500mg（B+Mor+Mg 组）。主要结局是术后 36 小时内视觉模拟评分疼痛曲线下面积。次要结局包括使用补救性镇痛剂的时间、患者满意度和副作用。
B+Mor+Mg 组患者在静息和运动时的疼痛评分和曲线下面积疼痛评分均较低，首次镇痛请求的时间延长，术后 24 小时的满意度评分升高。
与单独添加吗啡或镁或不添加任何药物相比，在 0.1%布比卡因 10mL 硬膜外腔中添加镁 500mg 和吗啡 1.5mg 可减轻术后疼痛。
