Kocman Iva Bacak, Krobot Renata, Premuzić Jadranka, Kocman Ivica, Stare Ranko, Katalinić Lea, Basić-Jukić Nikolina
Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb University Hospital Center, Zagreb, Croatia.
Department of Anesthesiology, Resuscitation and Intensive care, Varazdin General Hospital, Varazdin, Croatia.
Acta Clin Croat. 2013 Sep;52(3):289-94.
As an N-methyl-D-aspartate antagonist, magnesium sulfate has analgesic properties and reduces noxious input during surgery. The aim of the study was to determine the effect of preemptive intravenous low-dose magnesium sulfate on early postoperative pain after laparoscopic cholecystectomy. In this prospective, randomized study, 60 ASA I-II patients undergoing elective laparoscopic cholecystectomy were assigned to three groups (n = 20 each). After anesthesia induction, prior to surgical incision, patients received magnesium sulfate 5.0 mg/kg (group A), magnesium sulfate 7.5 mg/kg (group B) or saline intravenously (group C). General anesthesia was performed with the same drugs in all three groups. Postoperative pain intensities at rest, according to the visual analog scale (VAS 0-10), were evaluated at 1, 3, 6, 9 and 24 hours after surgery. According to the VAS scores, patients intravenously received metamizol 2.5 g (VAS 3-4), diclofenac 75 mg (VAS 5-7) or tramadol 1 mg/kg (VAS 8-10). VAS scores at 1 hour postoperatively were significantly lower in groups A (4.7 +/- 1.7; p < 0.05) and B (3.2 +/- 1.8; p < 0.01) than in group C (5.2 +/- 2.0). At 3 hours postoperatively, VAS score was significantly lower in group B (2.4 +/- 1.5) than in group A (3.7 +/- 1.8) or group C (3.8 +/- 2.3) (p < 0.05). After 6, 9 and 24 hours postoperatively, there were no differences in VAS scores among the groups. In conclusion, preemptive intravenous administration of both 5.0 mg/kg and 7.5 mg/kg of magnesium sulfate significantly reduced early postoperative pain after laparoscopic cholecystectomy, but 7.5 mg/kg was found to be more effective. There was no effect on pain reduction at 6, 9 and 24 hours after surgery and no adverse effects were recorded.
作为一种N-甲基-D-天冬氨酸拮抗剂,硫酸镁具有镇痛特性,并能减少手术期间的有害刺激输入。本研究的目的是确定术前静脉注射低剂量硫酸镁对腹腔镜胆囊切除术后早期疼痛的影响。在这项前瞻性随机研究中,60例接受择期腹腔镜胆囊切除术的美国麻醉医师协会(ASA)I-II级患者被分为三组(每组n = 20)。麻醉诱导后、手术切口前,患者静脉注射5.0 mg/kg硫酸镁(A组)、7.5 mg/kg硫酸镁(B组)或生理盐水(C组)。三组均使用相同的药物进行全身麻醉。术后根据视觉模拟评分法(VAS 0-10)评估静息时的疼痛强度,分别于术后1、3、6、9和24小时进行。根据VAS评分,患者静脉注射安乃近2.5 g(VAS 3-4)、双氯芬酸75 mg(VAS 5-7)或曲马多1 mg/kg(VAS 8-10)。术后1小时,A组(4.7±1.7;p < 0.05)和B组(3.2±1.8;p < 0.01)的VAS评分显著低于C组(5.2±2.0)。术后3小时,B组(2.4±1.5)的VAS评分显著低于A组(3.7±1.8)或C组(3.8±2.3)(p < 0.05)。术后6、9和24小时,各组VAS评分无差异。总之,术前静脉注射5.0 mg/kg和7.5 mg/kg硫酸镁均能显著减轻腹腔镜胆囊切除术后的早期疼痛,但7.5 mg/kg更为有效。术后6、9和24小时对疼痛减轻无影响,且未记录到不良反应。