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切口浸润硫酸镁复合布比卡因对术后疼痛的影响
The effects of wound infiltration magnesium sulphate and bupivacaine mixture on postoperative pain

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DOI:
作者:
龚寅, 汪正平，张俊杰， 黄小静
GONG yin, WANG zhengping, ZHANG junjie, HUANG xiao
作者单位:
上海市一人民医院麻醉科
Department of Anesthesiology, Shanghai First People’s Hospital, Shanghai Jiaotong University
关键词:
硫酸镁；切口浸润；术后镇痛
magnesium; wound infiltration; postoperative analgesia
摘要:
【摘要】：目的：观察切口浸润硫酸镁复合布比卡因对缓解术后疼痛以及减少术后阿片类药物应用的影响，同时比较复合不同剂量硫酸镁的镇痛效果。方法：60例ASA I-II择期于全麻下行腹式全子宫切除术的患者，随机分为3组，每组20例。术毕切口缝合时，于切口浸润硫酸镁与布比卡因的混合液。对照组（B组）：0.75%布比卡因5ml+生理盐水至20ml；小剂量硫酸镁组（BM150组）：0.75%布比卡因5ml+ MgS04 150mg+生理盐水至20ml；大剂量硫酸镁组（BM750组）：0.75%布比卡因5ml+ MgS04 750mg+生理盐水至20ml。记录术后1h，2h，4h，6h，8h，12h，24h以及48h静息以及咳嗽时视觉模拟评分（VAS）以及术后24h内芬太尼的累积使用量。结果：BM750组较BM150以及B组术后1h、2h、4h、6h和8h疼痛评分更低，并且累积芬太尼使用量更低。结论：切口浸润硫酸镁复合布比卡因可缓解腹式全子宫患者术后疼痛并且减少术后芬太尼的使用，而且其镇痛效应随着硫酸镁剂量的增大而增强。
【Abstract】Objective ：Obtain the influence of wound infiltration with MgSO4 and Bupivaine mixture on opioid analgesic requirements and improvement pain management, and compare if different dose of MgSO4 has the same effects. Methods This study is a prospective, randomized, double-blinded clinical trial. 60 ASA I or II patients scheduled for abdominal hysterectomy under general anesthesia were randomized into 3 groups(n=20 each). For patients, the wound was infiltrated blindly with the study medicine at the end of the surgery. Group B received 0.75% bupivacaine 5ml+saline total 20ml; Group BM150 received 0.75% bupivacaine 5ml+magnesium 150mg+ saline total 20ml; Group BM750 received 0.75% bupivacaine 5ml+magnesium 750mg+ saline total 20ml. The Visual Analog Scores(VAS) at rest and coughing were recorded separately 1h， 2h，4h, 6h, 8h, 12h, 24h and 48h after the surgery as well as the total fentanyl requirement in 24h after the surgery. Results Local magnesium administration results in a significant reduction in pain scores in Group BM750 compared with Group B and Group BM150. Total opioid analgesic consumption was signigicantly lower in Group BM750 than in Group B and Group BM150. Conclusion Wound infiltration magnesium is effective for postoperative analgesia in abdominal hysterectomy surgery and reduces opiod analgesic requirements, and this analgesic effect is enhanced as the magnesium sulphate use increased.

 

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