硫酸镁对腰椎减压融合内固定术患者七氟烷MACBAR的影响  

Effects of Magnesium Sulfate Intravenous Injection on MACBAR of Sevoflurane in Patients Undergoing Surgery of Lumbar Decompression and Internal Fixation

作　　者：夏丰娜 杜平均 王红[1] 张笑然[1] 王月兰[1] 薛娟[1] 许川雅[2] 

机构地区：[1]河北省第七人民医院麻醉科,河北定州073000 [2]北京大学第三医院麻醉科,北京100191

出　　处：《医学综述》2017年第11期2253-2257,共5页Medical Recapitulate

基　　金：河北省卫生厅指导项目(361028)

摘　　要：目的评价硫酸镁对腰椎减压融合内固定术患者七氟烷抑制应激反应的最低肺泡有效浓度(MACBAR)的影响。方法选择2013年5月至2014年11月北京大学第三医院择期行腰椎后路减压固定融合术患者40例,依据随机数字法分为硫酸镁组和对照组,各20例。硫酸镁组麻醉诱导前给予硫酸镁50 mg/kg,对照组诱导前给予等容量的0.9%氯化钠溶液。记录患者入室(T_0)﹑给药前(T_1)﹑给药后(T_2)﹑切皮前2 min(T_3)、切皮前1 min(T_4)﹑切皮后1 min(T_5)﹑2 min(T_6)﹑3 min(T_7)的平均动脉压和心率,按照改良序贯法测定切皮时七氟烷MACBAR值。结果给药后硫酸镁组患者的平均动脉压呈下降趋势,硫酸镁组患者的平均动脉压在切皮后变化较对照组不明显,两组平均动脉压组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05);两组患者的心率在切皮前与T_0比有所下降,时点间比较差异有统计学意义(P<0.05),切皮后与切皮前各时点变化不明显,组间比较差异无统计学意义(P>0.05)。硫酸镁组MACBAR值为(2.36±0.21)%,低于对照组(2.70±0.17)%(P<0.05)。结论诱导前给予硫酸镁50 mg/kg可以减小腰椎减压融合术患者切皮时七氟烷MACBAR值。Objective To observe the effects of magnesium sulfate on minimum alveolar concentration（MACBAR） of sevoflurane for blocking adrenergic response after surgical incision in patients undergoing surgery of lumbar decompression and internal fixation. Methods Forty patients undergoing lumbar decompression and internal fixation in Peking University Third Hospital from May 2013 to Nov. 2014 were included in the study, and assigned to a magnesium sulfate group and a control group according to the random number table method,20 cases each. The magnesium sulfate group received intrave- nous magnesium sulfate 50 mg/kg,while the control group received 0.9% saline. Mean arterial pressure（MAP） and heart rate（HR） at TO （ before induction ）, T1 （ before intravenous） , T2 （ after intravenous）, T3 （ 2 min before skin incision ）, T4 （1 min before skin incision）, T5 （1 rain after skin incision）, T6 （2 min after skin incision）, T7 （3 min after skin incision） were recorded. The MACBAR at skin incision was determined using improved sequential allocation method. Results After administration, the MAP in the magnesium sulfate group showed a downward trend, which was not significant compared with the control group＇s changes, the MAP between groups, time points, and interaction of groups and time points had significant differences（P 〈 0. 05）. HR of the two groups decreased before skin incision compared with To, and there was statistically significant difference between the time points （P 〈 0.05 ）, which did not change significantly after skin incision compared with before skin incision at each time point,there was no significant difference between groups（P 〉0.05）. The MACBAR of the magnesium group was （2.36 ±0.21 ） %, lower than the control group＇s （2.70 ± 0. 17） % （P 〈 0. 05 ）. Conclusion Magnesium sulfate administered by 50 mg/kg before induction of anesthesia reduces MACBAR of sevoflurane after surgical incision in patients undergoing surgery of lumbar decomp

关 键 词：腰椎减压融合内固定术 硫酸镁 七氟烷 抑制交感反应的最低肺泡浓度 

分 类 号：R614.2[医药卫生—麻醉学]