Salevitz Daniel, Olson Kathleen, Klanderman Molly, Mi Lanyu, Tyson Mark, Humphreys Mitchell, Misra Lopa
Department of Urology, Mayo Clinic Arizona, Mayo Clinic Phoenix, Phoenix, AZ, 85054, USA.
Flagstaff Surgical Associates, Flagstaff, AZ, USA.
Perioper Med (Lond). 2024 Sep 6;13(1):91. doi: 10.1186/s13741-024-00448-x.
To evaluate effects of intraoperative magnesium sulfate infusion on pain control and analgesic use in the postanesthesia care unit (PACU).
This is a retrospective review of patients undergoing robot-assisted radical prostatectomy (RARP) and endoscopic procedures of the bladder, prostate, and urethra from 2/2021 to 12/2021. Patients receiving Mg infusion (Mg group) received an intravenous 2-g bolus of Mg at anesthesia induction, followed by infusion of 1 g/h until procedure end. Outcomes were compared with patients who underwent similar procedures during this timeframe without Mg (Control). Endpoints were use of anticholinergic (AC) and belladonna and opium suppositories (BO), maximum pain score, and morphine milligram equivalents (MME) in PACU.
There were 182 patients, with 89 (48.9%) patients in the Mg group and 93 (51.1%) in the Control. Significantly, fewer patients in the Mg group were given AC/BO in PACU (9.0% vs. 21.7%, p = 0.02), with odds of using AC/BO which was 0.36 (95% CI 0.14, 0.83). No differences were found in pain score (p = 0.62) or MME administration (p = 0.94). In subgroup univariate analysis, only those who underwent bladder procedures had a significant difference in use of AC/BO (9.5% vs. 30.2%; p = 0.02). Across all surgeries, Mg infusion was associated with decreased use of AC/BO in the PACU (OR 0.34, p = 0.02); however, stratifying by procedure type did not find a difference in AC/BO use postoperatively.
Intravenous infusion of magnesium was found to decrease use of AC/BO in the PACU; however, this significance was lost after multivariable analysis stratifying by procedure type.
评估术中输注硫酸镁对麻醉后护理单元（PACU）疼痛控制和镇痛药物使用的影响。
这是一项对2021年2月至2021年12月期间接受机器人辅助根治性前列腺切除术（RARP）以及膀胱、前列腺和尿道内镜手术患者的回顾性研究。接受镁输注的患者（镁组）在麻醉诱导时静脉推注2克镁，随后以1克/小时的速度输注直至手术结束。将结果与在此时间段内接受类似手术但未使用镁的患者（对照组）进行比较。观察终点为PACU中抗胆碱能药物（AC）和颠茄与鸦片栓剂（BO）的使用情况、最大疼痛评分以及吗啡毫克当量（MME）。
共有182例患者，其中镁组89例（48.9%），对照组93例（51.1%）。值得注意的是，镁组在PACU中接受AC/BO治疗的患者明显较少（9.0%对21.7%，p = 0.02），使用AC/BO的几率为0.36（95%CI 0.14，0.83）。疼痛评分（p = 0.62）或MME给药量（p = 0.94）未发现差异。在亚组单因素分析中，只有接受膀胱手术的患者在AC/BO使用方面存在显著差异（9.5%对30.2%；p = 0.02）。在所有手术中，镁输注与PACU中AC/BO使用减少相关（OR 0.34，p = 0.02）；然而，按手术类型分层后未发现术后AC/BO使用存在差异。结论：发现静脉输注镁可减少PACU中AC/BO的使用；然而，在按手术类型进行多变量分析后，这种显著性消失了。
