硫酸镁改善腹腔镜妇科手术术后镇痛:一项双盲随机对照试验。

A. M. Sousa, G. M. Rosado, Jose de S Neto, G. Guimarães, H. Ashmawi
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引用次数: 30

摘要

研究目的比较腹腔镜手术中静脉滴注硫酸镁与酮罗拉酸的镇痛效果。设计双盲随机对照试验。学校附属教学医院。病人:60名妇女接受腹腔镜妇科肿瘤手术。干预措施:K组静脉滴注酮洛酸30 mg/kg,随后滴注生理盐水(K组),M组静脉滴注硫酸镁20 mg/kg,随后滴注2 mg kg(-1) h(-1) (M组)或全程静脉滴注生理盐水溶液20 mL,随后滴注生理盐水(S组)。测量术后疼痛、恶心、呕吐、镇静、阿片类药物消耗、至首次给药时间。主要结果:与安慰剂相比,硫酸镁在术后减少了阿片类药物的消耗,但在术中没有减少。酮咯酸减轻了恶心,而不是呕吐,但镁组没有。在所有观察期间,安慰剂组的疼痛强度均高于其他两组。在最初的60分钟内,镁组的疼痛强度低于酮罗拉酸组或安慰剂组。结论术中硫酸镁可改善术后疼痛控制,可作为阿片类药物的辅助剂,其作用与术初给予酮罗拉酸30mg相似。
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Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries: a double-blind randomized controlled trial.
STUDY OBJECTIVE The aim of this study is to compare the analgesic effect of intravenous infusion of magnesium sulfate to ketorolac during laparoscopic surgeries. DESIGN Double-blind randomized controlled trial. SETTING University-affiliated teaching hospital. PATIENTS Sixty women submitted to laparoscopic gynecologic oncology surgeries. INTERVENTIONS Intravenous ketorolac 30 mg in bolus followed by saline infusion (group K), intravenous magnesium sulfate 20 mg/kg in bolus followed by magnesium 2 mg kg(-1) h(-1) (group M) or intravenous saline solution 20 mL in bolus followed by saline infusion during the entire procedure (group S). MEASUREMENTS Postoperative pain, nausea, vomiting, sedation, opioid consumption, time to first dose of analgesic. MAIN RESULTS Magnesium sulfate reduced opioid consumption compared with placebo in the postoperative, but not in the intraoperative, period. Nausea, not vomiting, was reduced in ketorolac but not in the magnesium group. Pain intensity was higher in placebo than in the other 2 groups during all periods of observation. In the first 60 minutes, pain intensity was lower in the magnesium than in the ketorolac or the placebo group. CONCLUSION Intraoperative magnesium sulfate improves postoperative pain control, acting as an opioid-sparing adjuvant, and is similar to ketorolac 30 mg administered in the beginning of surgery.
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