CAJ | 학술논문

目的评价全凭静脉麻醉行乳腺癌根治术围术期输注硫酸镁对术中麻醉药物和术后静脉镇痛的影响.方法 68例ASAⅠ～Ⅱ级择期全麻下行乳腺癌改良根治术的女性患者(32～63岁)参加此次前瞻、随机、双盲、安慰剂对照临床研究.患者分别纳入硫酸镁组或安慰剂组,每组34例,分别在麻醉诱导前给予10%的硫酸镁50 mg/kg缓慢静脉推注作为负荷量,继而给予15 mg/ (kg ·h)连续输注或匹配的安慰剂.术中全凭静脉维持全身麻醉,术后均接受丁丙诺啡患者自控静脉镇痛.记录血流动力学变化、麻醉药物的使用量,通过视觉模拟评分量表评估患者术后即刻,术后30 min、4 h、24 h、48 h疼痛程度.结果与安慰剂组相比较,硫酸镁组肌松药和丁丙诺啡使用量少、疼痛评分低(P<0.05),硫酸镁组血清Mg2+浓度高于安慰剂组(P<0.05),丙泊酚和瑞芬太尼的使用量相似(P>0.05).结论全凭静脉麻醉行乳腺癌根治术围术期输注硫酸镁能明显降低肌松药、镇痛药的使用量,改善术后疼痛.
목적 평개전빙정맥마취행유선암근치술위술기수주류산미대술중마취약물화술후정맥진통적영향.방법 68례ASAⅠ～Ⅱ급택기전마하행유선암개량근치술적녀성환자(32～63세)삼가차차전첨、수궤、쌍맹、안위제대조림상연구.환자분별납입류산미조혹안위제조,매조34례,분별재마취유도전급여10%적류산미50 mg/kg완만정맥추주작위부하량,계이급여15 mg/ (kg ·h)련속수주혹필배적안위제.술중전빙정맥유지전신마취,술후균접수정병낙배환자자공정맥진통.기록혈류동역학변화、마취약물적사용량,통과시각모의평분량표평고환자술후즉각,술후30 min、4 h、24 h、48 h동통정도.결과 여안위제조상비교,류산미조기송약화정병낙배사용량소、동통평분저(P<0.05),류산미조혈청Mg2+농도고우안위제조(P<0.05),병박분화서분태니적사용량상사(P>0.05).결론 전빙정맥마취행유선암근치술위술기수주류산미능명현강저기송약、진통약적사용량,개선술후동통.
Objective To evaluate the effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirements and postoperative analgesia patient controlled intravenous analgesia in patients with modified radical mastectomy. Methods Sixty-eight female patients(32-63 y),ASA physical status I and Ⅱ undergoing modified radical mastectomy under total intravenous anaesthesia were included in the prospective, randomized, placebo controlled, double-blind study. Subjects were divided into two groups of 34 each group to receive either gabapentin magnesium sulphate 50 mg/ kg intravenous as a bolus and then 15 mg/ (kg·h) intravenous by continuous infusion or a matching placebo. Total intravenous anaesthesia was administered during anaesthesia maintenance, subjects received patient controlled intravenous buprenornhine analgesia during the postoperative period. The change of haemodynamics, the consumption of anesthetics were recorded. Pain scores were evaluated at 0 min,30 min, 4 h, 24 h and 48 h after surgery.Results The vecuronium requirement and postoperative buprenornhine consumption were reduced, postoperative pain scores were lower in the magnesium sulphate group compared with the placebo group(P﹤0.05). Serum magnesium concentrations in magnesium sulphate group were higher than that in placebo group after operation(P﹤0.05). The total amounts of propofol and remifentanil administered were similar in the two groups(P＞0.05). Conclusions Intraoperative intravenous magnesium sulphate reduces vecuronium requirements and postoperative analgesic consumption, attenuates postoperative pain.