Hua Xiaoxiao, Chen Yanling, Wu Zhi, Zheng Guangsen, Yang Dongye, Li Jing, Wu Qiaomei, Fan Wenguo
Department of Anesthesiology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China.
Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
Heliyon. 2024 Apr 25;10(9):e30342. doi: 10.1016/j.heliyon.2024.e30342. eCollection 2024 May 15.
To comprehensively understand the effects of intra-operative infusion of magnesium sulfate on patients who underwent orthognathic surgery, including remifentanil consumption, postoperative pain, postoperative nausea and vomiting (PONV), inflammatory response, and serum magnesium levels.
Seventy-five adult patients undergoing orthognathic surgery under general balanced anesthesia were randomly divided into two groups. One group (Group M) received 50 mg/kg of magnesium sulfate in 20 mL 0.9 % saline after intubation, followed by a continuous infusion at a rate of 15 mg/kg/h until 30 min before the anticipated end of surgery. The other group (Group C) received an equal volume of isotonic saline as a placebo. (Clinical trial registration number: chiCTR2100045981).
The primary outcome was remifentanil consumption. The secondary outcomes included the pain score assessed using the verbal numerical rating scale (VNRS) and PONV assessed using a Likert scale. Remifentanil comsumption in Group M was lower than Group C (mean ± SD: 0.146 ± 0.04 μg/kg/min vs. 0.173 ± 0.04 μg/kg/min, = 0.003). At 2 h after surgery, patients in Group C suffered more severe PONV than those in Group M (median [interquartile range, IQR]: 1 [3] vs. 1 [0], mean rank: 31.45 vs. 42.71, = 0.040). At post-anesthesia care unit (PACU), postoperative pain in Group C was severe than Group M (3 [1] vs. 3 [0], mean rank: 31.45 vs. 42.71, = 0.013). Changes in haemodynamics and surgical field scores did not differ between the groups (all > 0.05). The levels of cytokines (IL-4, IL-6, IL-8, IL-10, TNF-a, and MIP-1β) were not significantly different between the groups after surgery (all > 0.05). Postoperative serum magnesium levels in Group C were lower than those in Group M (0.74 ± 0.07 mmol/L vs. 0.91 ± 0.08 mmol/L, = 0.000) and the preoperative level (0.74 ± 0.07 mmol/L vs. 0.83 ± 0.06 mmol/L, = 0.219).
In orthognathic surgery, magnesium sulfate administration can reduce remifentanil requirement and relieve PONV and postoperative pain in the early postoperative phase.
全面了解术中输注硫酸镁对接受正颌手术患者的影响，包括瑞芬太尼用量、术后疼痛、术后恶心呕吐（PONV）、炎症反应及血清镁水平。
75例在全身平衡麻醉下接受正颌手术的成年患者随机分为两组。一组（M组）在插管后于20 mL 0.9%盐水中给予50 mg/kg硫酸镁，随后以15 mg/kg/h的速率持续输注直至预计手术结束前30分钟。另一组（C组）接受等量等渗盐水作为安慰剂。（临床试验注册号：chiCTR2100045981）。
主要结局为瑞芬太尼用量。次要结局包括使用视觉数字评分量表（VNRS）评估的疼痛评分以及使用李克特量表评估的PONV。M组瑞芬太尼用量低于C组（均值±标准差：0.146±0.04μg/kg/min对0.173±0.04μg/kg/min，P = 0.003）。术后2小时，C组患者的PONV比M组更严重（中位数[四分位间距，IQR]：1[3]对1[0]，平均秩次：31.45对42.71，P = 0.040）。在麻醉后恢复室（PACU），C组术后疼痛比M组更严重（3[1]对3[0]，平均秩次：31.45对42.71，P = 0.013）。两组间血流动力学和手术视野评分的变化无差异（均P>0.05）。术后两组间细胞因子（IL-4、IL-6、IL-8、IL-10、TNF-α和MIP-1β）水平无显著差异（均P>0.05）。C组术后血清镁水平低于M组（0.74±0.07 mmol/L对0.91±0.08 mmol/L，P = 0.000）以及术前水平（0.74±0.07 mmol/L对0.83±0.06 mmol/L，P = 0.219）。
在正颌手术中，给予硫酸镁可减少瑞芬太尼用量，并在术后早期缓解PONV和术后疼痛。
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