围术期输注硫酸镁对全麻术后吗啡用量的影响  

Effects of Magnesium Sulfate on Morphine Demanding During Postoprative Analgesia.

作　　者：程芳[1] 陈静[2] 李加凯[1] 刘功俭[3] 

机构地区：[1]江苏省连云港市第一人民医院东方医院麻醉科,222042 [2]江苏省连云港市海港医院麻醉科 [3]徐州医学院附属医院麻醉科

出　　处：《医学研究杂志》2006年第5期61-63,共3页Journal of Medical Research

摘　　要：目的观察围术期输注硫酸镁对全麻术后吗啡用量的影响。方法选择40例ASAⅠ-Ⅱ级,拟在全麻下行全子宫切除术的患者,随机分为对照组(NS组)和硫酸镁组(MG组)。MG组术前静脉给予25%MgSO4负荷剂量25mg/kg(即0·1ml/kg),继以200mg/h持续输注至术后48h。NS组给予同等容量的生理盐水以同样技术予以输注。术后应用吗啡静脉自控镇痛(PCIA),记录患者首次要求镇痛的时间(患者主观VAS评分>4cm时),术后4、8、18、24、48h疼痛评分(VAS)、镇静评分(OAA/S)、吗啡用量及术后恶心、呕吐情况。结果从手术结束到患者首次要求镇痛的时间,MG组30·2±5·2min比NS组20·0±4·3min显著延长(P<0·01)。MG组术后48h内吗啡的总用量22·8±4·8mg,显著低于NS组27·0±6·8mg(P<0·01)。术后恶心呕吐的发生率MG组与NS组分别为10%和30%(P<0·05)。结论全麻下行子宫切除术的病人,围术期输注硫酸镁可延长患者术后首次要求镇痛的时间,减少术后48h内吗啡的用量及术后恶心呕吐的发生率。Objective To observe effects of magnesium sulfate （MgSO4） on the morphine requiement during postoperative analgesia . Methods Forty ASA Ⅰ-Ⅱ undergoing elective abdominal hysterectomy with general anesthesia adult patients were randmly divided to 2 groups： Group 1 normal saline group NS , n1 = 20, Group 2 magnesium group MG , n2 = 20, The patients in group MG received 2.5% magnesium sulfate 25mg/kg （0. 1ml/kg） intravenously beforestart of surgery and 200 mg/h for the next 48 h.The patients in group NS received the same volume of saline. Postoperative patient - controlled intravenous analgesia （PCIA） with morphine started when subjective pain intensity （visual analog scale, VAS） was 〉 4cm. VAS and sedation status （OAA/S） were assessed at 4, 8, 18, 24 and 48h during postoperative period. Morphine consumption and complications during 48h after operation were recorded. Results Morphine consumption was significantly lower in group MG 22.8 ±4.8 mg than that in group NS 27.0±6.8 mg in48h PCIA （P 〈 0.01） .The mean time to initiation of PCIA was significantly longer in group MG （30.2 ±5.2） min than that in group NS （20.0± 4.3） rain （ P 〈 0.01 ） .The incidence of postoperative nausea and vomiting was significantly less in group MG （ P 〈 0.05） . Conclusion Peffoperative use of magnesium sulfate intravenously significantly reduces postoperative morphine consumption and incidence of nausea and vomiting in the patients given PCIA.

关 键 词：硫酸镁 自控镇痛 吗啡 全麻 

分 类 号：R614.2[医药卫生—麻醉学]