【罂粟摘要】静脉注射硫酸镁在开腹手术术后的镇痛效果:一项随机双盲研究

静脉注射硫酸镁在开腹手术术后的镇痛效果:一项随机双盲研究  

贵州医科大学

麻醉与心脏电生理课题组

翻译：安丽   

编辑：潘志军   

审校：曹莹

背景：据文献报道，硫酸镁具有镇痛作用，其机制可能因镁可抑制钙通道和N -甲基-D -酰基磷酸酯(NMDA)受体而缓解疼痛，降低阿片类药物的摄入量。本研究旨在评价硫酸镁在开腹手术术后的镇痛效果。

方法：这项随机双盲研究中，纳入需腹部手术的患者84例，随机分为两组。即静脉注射硫酸镁组与对照组。静脉注射硫酸镁组：于术后1h内静脉输注硫酸镁25 mg/kg后，随后持续24h内静脉输注硫酸镁100 mg/kg; 对照组：术后24h内输注同等容积的生理盐水。主要检测指标为：每3h使用数字评分量表（NRS）评估疼痛强度，次要检测指标为：如果NRS>3，则使用吗啡并进行评估。使用SPSS 19软件对结果进行分析，P<0.05差异具有统计学意义。

结果：两组之间患者的一般情况差异无显著统计学意义。两组的疼痛强度在第1h和第3h无显著差异(P = 0.393和P = 0.172)，但在第6 ~ 24h，静脉注射硫酸镁组疼痛程度明显低于对照组（硫酸镁组为3.34±1，对照组为4.4±1.3,P = 0.001)。此外，两组在24 h内吗啡使用量有显著差异，（硫酸镁组为8±3.5 mg ，对照组为13.2±5.7 mg，P = 0.001)。

结论：在这项研究中，腹部手术后24小时静脉注射硫酸镁可缓解6小时后的疼痛强度，并减少吗啡的用量。

原始文献来源：

Arash Peivandi Yazdi, Mehrdad Esmaeeli, and Mehryar Taghavi Gilani.Effect of intravenous magnesium on postoperative pain control for major abdominal surgery: a randomized double-blinded study.Anesth Pain Med 2022;17:280-285.Doi.org/10.17085/apm.22156

英文原文 Effect of intravenous magnesium on postoperative pain control for major abdominal surgery: a randomized double-blinded study

Abstract

Background: This study aimed to evaluate the postoperative analgesic effect of magnesium sulfate during abdominal surgery.

Methods: This randomized double-blinded study involved 84 patients candidates for abdominal surgery into two same groups. In the magnesium group, at first 25 mg/kg/1 h magnesium sulfate; and then, 100 mg/kg/24 h was infused in the intensive care unit. The pain intensity (the primary outcome), was assessed using the numeric rating scale (NRS) every 3 h. If the NRS was > 3, morphine (as a secondary outcome) was used and evaluated. The results were analyzed using SPSS ver. 19 software, and statistical significance was set at P < 0.05.

Results: Demographic parameters were similar between the groups. The pain intensity were similar at first and then at the third hour in both groups (P = 0.393 and P = 0.172, respectively), but thereafter between 6 and 24 h, the pain severity was significantly lower in the magnesium group (4.4 ± 1.3 in the control and 3.34 ± 1 in the magnesium group at 6th hour and P = 0.001). In addition, morphine intake in the first 24 h in the two groups had a significant difference, with 13.2 ± 5.7 mg in control group and 8 ± 3.5 mg in magnesium

group (P = 0.001).

Conclusions: In this study, intravenous magnesium sulfate after abdominal surgeries for 24h resolved the pain intensity after six hours and reduced morphine dosage.

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