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作 者:陈洁[1] 汪小海[1,2] 汤春艳 葛卫红[3] CHEN Jie;WANG Xiaohai;TANG Chunyan;GE Weihong(Department of Anesthesiology,Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,China;Department of Anesthesiology,the Affiliated Taikang Xianlin Drum Tower Hospital of Nanjing University,Nanjing 210046,China;Department of Pharmacy,Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,China)
机构地区:[1]南京大学医学院附属鼓楼医院麻醉科,南京210008 [2]南京大学医学院附属泰康仙林鼓楼医院麻醉科,南京210046 [3]南京大学医学院附属鼓楼医院药学部,南京210008
出 处:《医药导报》2024年第10期1651-1655,共5页Herald of Medicine
基 金:南京市科技卫生发展专项基金资助项目(YKK21100)。
摘 要:在疼痛治疗过程中为了减少阿片药物的应用,已经尝试引入辅助镇痛剂。越来越多的数据表明N-甲基-D-天冬氨酸(NMDA)受体拮抗剂可能具有增强阿片样物质的镇痛作用,诸多研究显示硫酸镁的辅助镇痛作用在疼痛治疗和围手术期麻醉方面表现出很好的应用前景。硫酸镁应用于疼痛治疗的药理学机制主要是其具有NMDA偶联通道的生理电压依赖性阻断剂的作用,其抗伤害性作用与镁阻断钙内流,从而抑制中枢敏感化并降低先前存在的痛觉过敏有关。该文综述硫酸镁在围手术期应用的现状,主要介绍硫酸镁静脉给药、鞘内给药、局部给药的辅助镇痛效果和减少阿片类药物消耗作用,以及在无阿片类药物麻醉方案中的作用及应用前景。During the pain treatment process,to reduce the use of opioids,alternative pain relievers have been used.Increasing data indicated that N-methyl-D-aspartic acid(NMDA)receptor antagonists may enhance the analgesic effect of opioids.Furthermore,numerous studies have shown that the auxiliary analgesic effect of magnesium sulfate has a good application prospect in pain treatment and perioperative anesthesia.The primary pharmacological mechanism of magnesium sulfate in pain treatment is that it acts as a physiological voltage-dependent blocker of NMDA coupling channels,and its anti-nociceptive effect is related to magnesium blocking calcium inflow,thereby inhibiting central sensitization and reducing preexisting hyperalgesia.This paper reviewed the current application of magnesium sulfate in perioperative period,focusing on its auxiliary analgesic effect through intravenous,intrathecal,and local administration,and the reduction of opioid consumption.As well as its potential role and application prospects in opioid-free anesthesia program.
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