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| 硫酸镁对全麻下止血带相关高血压和术后疼痛的影响 |
| Effect of magnesium sulphate on tourniquet-related hypertension and postoperative pain under general anesthesia |
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| DOI：10.12089/jca.2019.07.011 |
| 中文关键词: 硫酸镁 止血带相关高血压 术后疼痛 |
| 英文关键词: Magnesium sulphate Tourniquet-related hypertension Postoperative pain |
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| 中文摘要: |
目的 探讨硫酸镁对全麻下止血带相关高血压和术后疼痛的影响。
方法 选择全麻下行单侧下肢手术且需要使用止血带的患者60例，男25例，女35例，年龄30~65岁，ASA Ⅰ或Ⅱ级，随机分为硫酸镁组（M组）和对照组（C组），每组30例。M组于诱导后5 min使用止血带前静脉泵注硫酸镁30 mg/kg，泵注时间为10 min，随后以15 mg·kg-1·h-1速度维持至松开止血带，C组同样方法泵注等容量生理盐水。记录入室后（T0）、诱导后5 min（T1）、止血带充气30 min（T2）、充气1 h（T3）、放气前（T4）、放气后5 min（T5）时HR、SBP、DBP、每搏量（SV）、心输出量（CO）、心脏指数（CI）。记录术中止血带相关高血压发生情况和降压药使用情况。记录术后3、6、24和48 h静息时VAS评分和Ramsay镇静评分。记录术后补救镇痛情况和寒战、恶心、呕吐、心动过缓、低血压、腱反射消失、呼吸抑制等不良反应发生情况。
结果 T2—T5时M组HR明显慢于C组（P<0.05）；T2—T4时M组SBP和DBP明显低于C组（P<0.05）；T2—T5时M组SV明显高于C组（P<0.05）；M组术中止血带相关高血压发生率和降压药物使用率明显低于C组（P<0.05）。术后3、6和24 h M组静息时VAS评分明显低于C组（P<0.05）。
结论 全麻下静脉应用硫酸镁可以降低止血带相关高血压发生率和缓解术后疼痛。 |
| 英文摘要: |
Objective To investigate the effect of magnesium sulphate on tourniquet-related hypertension and postoperative pain under general anesthesia.
Methods Sixty patients, 25 males and 35 females aged between 30 and 65, ASA physical status Ⅰ or Ⅱ, scheduled for elective unilateral lower extremity surgery requiring tourniquet inflation were recruited and randomly divided into magnesium group (group M) and control group(group C). Patients in group M received intravenous magnesium sulphate 30 mg/kg within 10 min followed by 15 mg·kg-1·h-1 via an infusion pump until deflation. Patients in group C received the same volume of normal saline over the same period. Measurements included HR, SBP, DBP, stroke volume (SV), cardiac output (CO) and cardiac index (CI) at time after entering the room (T0), 5 min after induction (T1), 30 min (T2) and 60 min (T3) after inflation, time before (T4) and 5 min (T5) after deflation. The incidence of tourniquet-related hypertension (TIH) and the use of antihypertensive drugs during operation were recorded. The VAS scores at rest and Ramsay sedation scores of patients were observed at 3, 6, 24 and 48 h after surgery. The number of remedial analgesics and the amount of chills, nausea, vomiting, bradycardia, hypotension, tendon reflex disappearance, respiratory depression and other adverse reactions were also recorded.
Results HR was significantly decreased at T2- T5, SBP and DBP were significantly decreased at T2- T4， while SV was significantly increased at T3- T6 in group M than in group C (P < 0.05). The incidence of tourniquet-related hypertension and use of antihypertensive drugs were significantly decreased in group M than in group C (P < 0.05). The VAS scores at rest were lower in group M than in group C 3, 6 and 24 h after surgery (P < 0.05).
Conclusion Intravenous magnesium sulfate is effective and safe in preventing tourniquet-related hypertension and relieving postoperative pain under general anesthesia. |
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