文章摘要
全莉妮 杨慧芳 杜晓蓉 迟岩 徐咏梅.静注硫酸镁对腰硬联合麻醉患者术后疼痛和寒战反应的影响[J].,2015,15(8):1522-1524
静注硫酸镁对腰硬联合麻醉患者术后疼痛和寒战反应的影响
Effects of Intravenous MagnesiumSulphate during CSEA on PostoperativeAnalgesia and Postoperative Shivering
  
DOI:
中文关键词: 硫酸镁  术后镇痛  术后寒战  视觉模拟评分法  镇痛药用量
英文关键词: Magnesiumsulfate  Postoperative analgesia  Shivering  VAS  Postoperative analgesic requirements
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作者单位
全莉妮 杨慧芳 杜晓蓉 迟岩 徐咏梅 哈尔滨医科大学附属第二医院 
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中文摘要:
      目的:探讨腰硬联合麻醉中静脉输注50 mg/kg和25 mg/kg两种剂量的硫酸镁对术后镇痛和寒战的的影响。方法:90 名腰硬 联合麻醉(CSEA)下行全子宫切除术的患者随机分成3组。在腰麻注药后即刻,MGI组30 分钟内静脉输注硫酸镁25 mg/kg继以 10 mg/kg/h 的速度输注至手术结束;MGⅡ组输注硫酸镁50 mg/kg,然后以10 mg/kg/h 的速度输注;C 组注入等量生理盐水。观察 术后24 小时的疼痛评分(视觉模拟评分法:VAS),术后镇痛药物的用量,寒战的发生率。结果:三组术后镇痛用药量由低到高依 次为MGII组,MGI 组,C 组(P < 0.001)。术后VAS评分,MGII组较C 组减少,(P < 0.05);在12 h,24 h,MGII组较MGI组减少, MGI组在2 h,4 h较C组减少(P < 0.05)。术后寒战在C 组发生率最高,在MGI组与MGII组发生率少,组间有统计学差异(P = 0.007)。结论:腰硬联合麻醉中静脉输注两种剂量的硫酸镁均可以改善术后镇痛,减少术后寒战的发生率,大剂量硫酸镁更有 效,但也可能伴随更大的血流动力学波动。
英文摘要:
      Objective:To evaluated the effects of i.v.infusion of magnesium sulphate with two different doses of 50 mg/kg and 25 mg/kg during combined-spinal-epidural-anaesthesia (CSEA) on postoperative analgesia and shivering.Methods:90 patients undergoing abdominal panhysterectomy surgery under CSEA were randomly divided into 3 groups. Just after the intrathecal injection, Group MGI received an iv. MgSO4 of 25 mg/kg within 30 minute, followed by 10 mg/kg/h infusion until the end of operation. Group MGII received 50 mg/kg of MgSO4 followed by 10 mg/kg/h infusion. Group C received an equal volume of physiological saline. Postoperative pain scores (VAS), analgesic consumption, and the incidences of shivering were evaluated.Results:Cumulative postoperative analgesic consumptions was lowest in Group MGII(P<0.001), and highest in group C (P<0.05). VAS was significantly lower in Group MGII than in group C. VAS at 12 h, 24 h after surgery was significantly lower in Group MGII than in group MGI (P<0.05). VAS of Group MGI at 2 h, 4 h after surgery was lower than in group C, (P<0.05 ). The incidences of shivering were lower in group MGI and MGI than in group C (P=0.007).Conclusion:I.V. infusion of magnesium sulphate with two different doses during CSEA improve postoperative analgesia and reduce the incidences of shivering. High dose of magnesium sulphate was more effective, however, the influences on hemodynamics may also increase.
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