CAJ | 학술논문

目的：探讨硫酸镁对神经外科手术术中血流动力学、麻醉镇痛药用量及术后镇痛效果的影响。方法将择期行神经外科手术的患者40例随机分为输注硫酸镁组（ M组）和生理盐水组（ S组）。记录和比较两组在基础时刻（T1）、诱导前（T2）、诱导后（T3）、气管插管后即刻（T4）、插管后3 min（T5）、手术开始（T6）、肿瘤切除（T7）、缝皮（T8）和气管拔管（T9）时的平均动脉压（MAP）和心率（HR），术中舒芬太尼和维库溴铵每分钟的的平均使用量，术后l、4、8、12、24 h的视觉模拟评分。结果 M组T3、T4、T8、T9时的MAP值显著低于S组（P＜0.05）；T5、T6、T7时组间MAP值比较差异不明显（P＞0.05）。 M组T4、T6、T8和T9时的HR值均显著低于S组（ P＜0.01）。 M组麻醉性镇痛药舒芬太尼和肌松药维库溴铵的平均输注速度均显著低于S组（P＜0.01）。术后4 h和8 h，M组的VAS评分均显著低于S组（P＜0.05）。结论硫酸镁用于神经外科手术麻醉，不仅可稳定血流动力学，而且能减少术中全麻药用量，具有良好的术后镇痛效果。
목적：탐토류산미대신경외과수술술중혈류동역학、마취진통약용량급술후진통효과적영향。방법장택기행신경외과수술적환자40례수궤분위수주류산미조（ M조）화생리염수조（ S조）。기록화비교량조재기출시각（T1）、유도전（T2）、유도후（T3）、기관삽관후즉각（T4）、삽관후3 min（T5）、수술개시（T6）、종류절제（T7）、봉피（T8）화기관발관（T9）시적평균동맥압（MAP）화심솔（HR），술중서분태니화유고추안매분종적적평균사용량，술후l、4、8、12、24 h적시각모의평분。결과 M조T3、T4、T8、T9시적MAP치현저저우S조（P＜0.05）；T5、T6、T7시조간MAP치비교차이불명현（P＞0.05）。 M조T4、T6、T8화T9시적HR치균현저저우S조（ P＜0.01）。 M조마취성진통약서분태니화기송약유고추안적평균수주속도균현저저우S조（P＜0.01）。술후4 h화8 h，M조적VAS평분균현저저우S조（P＜0.05）。결론류산미용우신경외과수술마취，불부가은정혈류동역학，이차능감소술중전마약용량，구유량호적술후진통효과。
Objective To evaluate the effects of magnesium sulphate on the intraoperative heamodynamics, anaesthetic requirements and postoperative analgesia in patients undergoing e-lective neurosurgery.Methods Forty patients undergoing elective neurosurgery were included in one of two parallel groups( control group, n=20;magnesium group, n=20) .The mean ar-terial pressure and HR were recorded and compared at various time points as follows:baseline (T1), before anaesthesia induction (T2), after anaesthesia induction(T3), immediately after intubation(T4), 3 min after intubation(T5), surgery inception(T6), tumor recection(T7), skin closed ( T8 ) and extubation ( T9 ) .Meanwhile, the average infusion rate of vecuronium and sufentanil as well as the VAS at 1, 4, 8, 12, 24 h postoperative were recorded.Results The mean arterial pressure at time T3, T4, T8, T9 of group M were significantly lower com-pared with group S at the same time( P<0.05) , but no significant difference was found in the MAP at time T5, T6, T7 between two groups(P>0.05).The HR of group M at time T4, T6, T8, T9 were all obviouly lower than those of group S(P<0.01).The average infusion rates of sufentanil and vecuronium bromide of group S were both significantly lower than those of group S( P<0.01) .4 h and 8 h after operation, the VAS score of group M was significantly lower than that of group S ( P<0.05 ) .Conclusion Magnesium administration could not only stabi-lize the haemodynamics, but also reduce the intraoperative dosage of general anesthetics and have good postoperative anlgesia effect in the application of neurosurgery operation.