硫酸镁作为芬太尼辅助用药在宫腔镜检查监测麻醉护理中的镇痛效果

Analgesic Effects of Magnesium Sulphate as an Adjuvant to Fentanyl for Monitored Anaesthesia Care During Hysteroscopy.

作者信息

Mishra Sonal, Jain Siddharth, Purohit Shobha, Lal Girdhari, Sharma Neelu

机构信息

Anesthesiology, Sawai Man Singh (SMS) Medical College, Jaipur, IND.

Orthopedics, All India Institute of Medical Sciences, Bhopal, IND.

出版信息

Cureus. 2023 Aug 14;15(8):e43458. doi: 10.7759/cureus.43458. eCollection 2023 Aug.

DOI:10.7759/cureus.43458

PMID:37711929

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10498801/

Abstract

BACKGROUND

Magnesium sulphate (MgSO4) is conventionally used in the treatment of eclampsia, refractive arrhythmias, asthma, etc. In our study, we aimed to study the analgesic effects of MgSO4 as an adjuvant to fentanyl and reduce the intraoperative opioid requirement to decrease their adverse effects.

METHODS

A total of 122 patients scheduled for hysteroscopy were randomly divided into two groups. Patients in the magnesium group (group A) received intravenous MgSO4 50 mg/kg in 100 ml of isotonic saline over 15 minutes before anaesthesia induction and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group (group B) received an equal volume of isotonic saline as a placebo. All the patients were induced with fentanyl and propofol. Perioperative haemodynamic monitoring and postoperative assessment of pain were done.

RESULTS

Only 18% of the patients in group A required rescue analgesics as compared to 39.3% of patients in group B. The patients receiving MgSO4 displayed lower verbal numeric rating scale scores in the postoperative period. In addition, the intraoperative requirement of fentanyl (101 (21.33) vs. 144 (28.4) µg, mean (SD)) and propofol (121 (13.3) vs. 140 (16.5) mg, mean (SD)) was significantly lower in group A as compared to that in group B.

CONCLUSION

MgSO4, when administered as an adjuvant to opioids, provided effective postoperative analgesia thereby reducing the need for rescue analgesics. It also decreases intraoperative fentanyl consumption and its dose-related side effects.

摘要

背景

硫酸镁（MgSO4）传统上用于治疗子痫、难治性心律失常、哮喘等。在我们的研究中，我们旨在研究硫酸镁作为芬太尼辅助药物的镇痛效果，并减少术中阿片类药物的用量以降低其不良反应。

方法

总共122例计划进行宫腔镜检查的患者被随机分为两组。硫酸镁组（A组）患者在麻醉诱导前15分钟内静脉输注100 ml等渗盐水中的50 mg/kg硫酸镁，然后以每小时15 mg/kg的速度持续静脉输注。对照组（B组）患者接受等体积的等渗盐水作为安慰剂。所有患者均用芬太尼和丙泊酚诱导麻醉。进行围手术期血流动力学监测和术后疼痛评估。

结果

A组仅18%的患者需要急救镇痛，而B组为39.3%。接受硫酸镁的患者在术后时期的言语数字评定量表得分较低。此外，A组术中芬太尼的需求量（平均（标准差）为101（21.33） vs. 144（28.4）µg）和丙泊酚的需求量（平均（标准差）为121（13.3） vs. 140（16.5）mg）明显低于B组。