Elsharkawy Reem Abdelraouf, Farahat Tamer Elmetwally, Abdelhafez Mohamed Sayed
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt.
J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):328-334. doi: 10.4103/joacp.JOACP_1_18.
Magnesium is a physiological antagonist of NMDA receptor and a calcium channel blocker. This study was designed to test the analgesic effect of magnesium sulfate (MgSO) when added to epidural anesthesia in mild pre-eclampsia.
Sixty parturients with mild pre-eclampsia were allocated randomly to two equal groups. The Placebo group received 20 ml levobupivacaine hydrochloride 0.5% plus 5 ml isotonic saline 0.9% using two separate syringes. The Magnesium group received the same amount of local anesthetic plus 5 ml of 10% MgSO(500 mg) using two separate syringes. The primary outcome was pain free period. While, the secondary outcomes were the onset of motor block and the time needed to achieve complete motor block. The analgesic profile was evaluated by visual analog scale (VAS) during rest or motion, the time to first request for analgesia, and the total analgesic consumption.
The pain-free period was significantly longer in the Magnesium group (311.3 ± 21.4) compared to placebo group (153.1 ± 22.18). The total postoperative consumption of fentanyl was significantly lower in the Magnesium group (42.4 ± 5.3) than that in the placebo group (94.4 ± 9.9), with a value 0. 01. Both the onset time of motor block and the time needed to achieve complete motor block were significantly shorter among the Magnesium group (4.4 ± 1.4 and 8.2 ± 0.4, respectively), with a value of 0. 01.
The addition of 500 mg MgSO to epidural anesthesia fastens both sensory and motor blockade and improves postoperative analgesic profile.
镁是N-甲基-D-天冬氨酸（NMDA）受体的生理拮抗剂及钙通道阻滞剂。本研究旨在测试硫酸镁（MgSO）添加至硬膜外麻醉用于轻度子痫前期时的镇痛效果。
60例轻度子痫前期产妇被随机分为两组，每组人数相等。安慰剂组使用两个单独的注射器，给予20 ml 0.5%左旋布比卡因加5 ml 0.9%等渗盐水。硫酸镁组使用两个单独的注射器，给予相同剂量的局部麻醉药加5 ml 10% MgSO（500 mg）。主要观察指标为无痛期。次要观察指标为运动阻滞的起效时间及达到完全运动阻滞所需时间。通过视觉模拟评分法（VAS）评估静息或运动时的镇痛情况、首次要求镇痛的时间及总镇痛药物消耗量。
硫酸镁组的无痛期（311.3±21.4）明显长于安慰剂组（153.1±22.18）。硫酸镁组术后芬太尼的总消耗量（42.4±5.3）明显低于安慰剂组（94.4±9.9），P值为0.01。硫酸镁组运动阻滞的起效时间及达到完全运动阻滞所需时间均明显缩短（分别为4.4±1.4和8.2±0.4），P值为0.01。
硬膜外麻醉中添加500 mg MgSO可加快感觉和运动阻滞，并改善术后镇痛情况。
