硫酸镁改善小儿腹腔镜手术麻醉效果的观察  

Observation of magnesium sulfate in improving anesthesia effect in children undergoing laparoscopic surgery

作　　者：文质斌 董英伟[1] Wen Zhibin;Dong Yingwei(Department of Anesthesiology,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科,哈尔滨150000

出　　处：《新医学》2020年第6期450-454,共5页Journal of New Medicine

摘　　要：目的探讨麻醉前静脉滴注硫酸镁对改善小儿腹腔镜手术麻醉效果的作用。方法将择期行腹腔镜手术的80例患儿随机分为观察组及对照组各40例,于麻醉诱导前给予观察组患儿40 mg/kg硫酸镁静脉滴注,对照组则给予同等剂量的生理盐水,2组患儿采取同样的麻醉诱导、维持方案。记录2组患儿诱导前(T0)、插管后(T1)、气腹建立后(T2)、手术结束时(T3)、拔管后(T4)5个时间点的心率、平均动脉压;记录术后不良反应的发生率,包括气道痉挛、呼吸抑制、恶心呕吐、寒战等;记录患儿T4、拔管后30 min(T5)及拔管后1 h(T6)3个时间点的躁动评分及疼痛评分。结果观察组患儿在T1、T2时刻的平均动脉压、心率以及T4时刻的平均动脉压均低于对照组,且血流动力学波动更小(P均<0.05)。观察组患儿在T4及T5时的躁动评分及疼痛评分均低于对照组(P均<0.05)。在患儿不良反应的观察中,观察组患儿气道痉挛的发生率低于对照组,但2组比较差异无统计学意义(P>0.05)。结论麻醉诱导前给予患儿40 mg/kg硫酸镁可稳定其术中的血流动力学,减轻其术后疼痛,降低其苏醒期躁动的发生率,且不增加术后气道并发症的发生率。Objective To evaluate the effect of intravenous administration of magnesium sulfate on improving the anesthesia effect in children undergoing laparoscopic surgery.Methods Eighty children undergoing elective laparoscopic surgery were randomly assigned into the observation(n=40)and control groups(n=40).Prior to anesthesia induction,40 mg/kg of magnesium sulfate was intravenously administered in the observation group,and an equivalent dose of normal saline was given in the control group.The same anesthesia induction and anesthesia maintenance regimes were adopted in two groups.The heart rate and mean blood pressure(MBP)were recorded in two groups at five time points:before induction(T0),after intubation(T1),after the establishment of the pneumoperitoneum(T2),the end of surgery(T3),after extubation(T4),respectively.The incidence of postoperative adverse reactions including airway spasm,respiratory depression,nausea and vomiting and shivering,was recorded in two groups.The agitation and pain scores of the children were assessed after extubation(T4),30 min after extubation(T5)and 1 h after extubation(T6),respectively.Results At T1 and T2,the MBP and heart rate in the observation group were significantly lower than those in the control group.At T4,the MBP in the observation group was considerably lower than that in the control group,and the hemodynamic fluctuation in the observation group was significantly smaller than that in the control group(all P<0.05).In the observation group,the agitation and pain scores at T4 and T5 were significantly lower compared with those in the control group(both P<0.05).Regarding the adverse reactions,the incidence of airway spasm in the observationb group was lower than that in the control group,but there was no significant difference between them(P>0.05).Conclusions Administration of 40 mg/kg of magnesium sulfate before anesthesia induction can stabilize intraoperative hemodynamics,mitigate postoperative pain,lower the incidence of agitation during the recovery period in children,and the

关 键 词：硫酸镁 小儿 腹腔镜 

分 类 号：R726.1[医药卫生—儿科]