S E Silva Filho, G F Matias, S Dainez, M A M C Gonzalez, F Angelis, C Bandeira, F B Soares, J E Vieira
Department of Anesthesiology, Hospital da Sociedade Portuguesa de Beneficência de Santos, Santos, Brazil.
Hospital da Beneficência Portuguesa de Santos, Santos, Brazil.
Anesthesiol Res Pract. 2025 Mar 19;2025:8854830. doi: 10.1155/anrp/8854830. eCollection 2025.
Magnesium sulfate reduces opioid use and its associated side effects. However, no consensus exists on whether the optimal dosing should be based on actual body weight or adjusted ideal body weight. The primary objective of this study was to compare postoperative analgesia after magnesium sulfate infusion, using doses calculated based on actual body weight versus adjusted ideal body weight. This prospective, randomized, double-blind, controlled clinical trial included 75 participants who underwent target-controlled intravenous general anesthesia. The participants were divided into three groups: a control group (CG), a group receiving magnesium sulfate calculated by actual body weight (AWG), and a group receiving magnesium sulfate calculated based on the adjusted ideal body weight (IWG). The AWG had significantly lower pain scores than the CG ( < 0.001) and IWG (=0.017). Opioid use was similar between the AWG and IWG, but significantly higher in the CG (AWG = IWG, =0.08; CG > AWG, < 0.001; CG = IWG, 0.03). The increase in magnesium concentration did not reach clinically relevant levels. Neuromuscular blockade latency decreased in the groups receiving magnesium sulfate ( < 0.001 in both comparisons) compared to the CG. Calculating the dose of magnesium sulfate based on actual body weight enhances postoperative analgesia. The increase in magnesium concentration was not clinically significant and did not interfere with the action of cisatracurium in the groups receiving magnesium sulfate. ClinicalTrials.gov identifier: NCT04645719.
硫酸镁可减少阿片类药物的使用及其相关副作用。然而，对于最佳剂量应基于实际体重还是调整后的理想体重，目前尚无共识。本研究的主要目的是比较基于实际体重与调整后的理想体重计算剂量的硫酸镁输注后的术后镇痛效果。这项前瞻性、随机、双盲、对照临床试验纳入了75名接受靶控静脉全身麻醉的参与者。参与者被分为三组：对照组（CG）、按实际体重计算接受硫酸镁的组（AWG）和按调整后的理想体重计算接受硫酸镁的组（IWG）。AWG的疼痛评分显著低于CG（<0.001）和IWG（=0.017）。AWG和IWG之间的阿片类药物使用情况相似，但CG中的使用量显著更高（AWG = IWG，=0.08；CG > AWG，<0.001；CG = IWG，0.03）。镁浓度的升高未达到临床相关水平。与CG相比，接受硫酸镁的组中神经肌肉阻滞潜伏期缩短（两次比较均<0.001）。基于实际体重计算硫酸镁剂量可增强术后镇痛效果。在接受硫酸镁的组中，镁浓度的升高在临床上并不显著，且不干扰顺式阿曲库铵的作用。ClinicalTrials.gov标识符：NCT04645719。
