两种不同剂量硫酸镁作为选择性剖宫产子痫前期患者鞘内布比卡因辅助剂的比较:一项前瞻性双盲随机研究

Swapnil Tuteja, Apoorva Gupta, S. Choudhary, Roshni Panwar, Rajeshwar Zala, Ravina R Bhokan
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引用次数: 1

摘要

背景:鞘内硫酸镁作为一种安全有效的脊髓麻醉(SA)辅助剂正在逐渐兴起。本研究的目的是比较两种剂量的鞘内镁对先兆子痫孕妇的疗效。方法:对105例择期剖宫产术(CS)患者进行前瞻性随机双盲研究,随机分为C组、M50组和M75组,每组35人。M50组和M75组分别给予50%硫酸镁50 mg (0.1 ml)和50%硫酸镁75 mg (0.15 ml)。各组患者相应给予0.5%重布比卡因10 mg,配以生理盐水,使其总容积为2.2 ml。比较各组患者的感觉和运动阻滞特征、视觉模拟评分(VAS)评分、术后镇痛需求、血流动力学参数及不良反应。结果:与M50组和对照组相比,M75组感觉和运动阻滞特征明显延迟(P < 0.05)。与M50组和M75组相比,对照组VAS评分至6 h均显著高于M50组和M75组(P < 0.05)。M75组首次抢救镇痛时间(222.86±12.502 min)显著延长M50组(221.14±13.671 min)和对照组(127.43±11.464 min),差异有统计学意义(P < 0.05)。结论:50 mg和75 mg剂量的鞘内硫酸镁可延长子痫前期产妇选择性CS的镇痛时间,降低VAS评分,延迟首次救援镇痛需求,并在减少恶心和寒战发生率方面具有良好的不良反应。
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Comparison of two different doses of magnesium sulfate as an adjuvant to intrathecal bupivacaine in patients with pre-eclampsia undergoing elective cesarean section: A prospective double-blind randomized study
Background: Intrathecal magnesium sulfate is now emerging as a safe and effective adjuvant for spinal anesthesia (SA). The aim of the present study was to compare the efficacy of two doses of intrathecal magnesium in parturients with pre-eclampsia. Methods: This prospective randomized double-blind study was conducted on 105 parturients undergoing elective cesarean section (CS) who were randomized into three groups of 35 each: Group C, M50, and M75. Group M50 and group M75 received 50 mg of 50% (0.1 ml) and 75 mg of 50% (0.15 ml) magnesium sulfate, respectively. All of the groups received 10 mg of 0.5% heavy bupivacaine with normal saline accordingly to make a total volume of 2.2 ml. The sensory and motor block characteristics, visual analogue scale (VAS) score, post-operative analgesic requirements, hemodynamic parameters, and adverse effects were compared. Results: The sensory and motor block characteristics were significantly delayed in group M75 compared to group M50 and the control group (P < 0.05). VAS scores were significantly high in the control group up to 6 h as compared to group M50 and group M75 (P < 0.05). The time to first rescue analgesia was significantly extended in group M75 (222.86 ± 12.502 min) as compared to group M50 (221.14 ± 13.671 min) and the control group (127.43 ± 11.464 min) (P < 0.05). Conclusion: Intrathecal magnesium sulfate at doses of 50 mg and 75 mg in pre-eclamptic parturients undergoing elective CS results in prolonged duration of analgesia, decreased VAS scores and also delays the first rescue analgesic requirement with a favorable adverse effect profile in terms of decreased incidence of nausea and shivering.
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