Objective: To explore the effect of adding magnesium sulfate as an adjuvant to ropivacaine for posterior lumbar block (QLB) on postoperative pain relief and inflammatory response in patients undergoing laparoscopic appendectomy.
Methods: A total of sixty patients,26 males and 34 females, aged 18-60 years, BMI 18.5-30.0 kg/m2 ,ASA physical status Ⅰ or Ⅱ, who diagnosed with simple acute appendicitis and planned to undergo laparoscopic appendectomy in nanjing lishui district people's hospital were randomly divided into two groups: the ropivacaine group (group R) and the ropivacaine combined with magnesium sulfate group (group MR), 30 patients in each group. Thirty minutes before general anesthesia, the group R and group MR received bilateral QLB under ultrasound guidance. The group R was injected with 20 ml of 0.375% ropivacaine and 3 ml of physiological saline on each side, while the group MR was injected with 20 ml of 0.375% ropivacaine and 3 ml of 10% magnesium sulfate on each side. The difference in HR and MAP between before and 2 minutes after skin cutting (Δ HR and Δ MAP), the consumption of sufentanil during surgery and within 48 hours after surgery, the occurrence of rescue analgesia were recorded. The NRS scores at rest and during exercise in patients upon admission to PACU, 4, 12, 24, 36, and 48 hours postoperatively were recorded, respectively. The serum levels of interleukin-6 (IL-6) and tumor necrosis factor (TNF)-α before surgery (before nerve block), 4, 24, and 36 hours after surgery were measured, respectively. The occurrence of adverse effects were observed.
Results: Compared with group R, the consumption of sufentanil within 48 hours after surgery in group MR was lower (P < 0.05), the NRS scores during exerciseof group MR 24 and 48 hours after surgery were significantly lower (P < 0.05), serum IL-6 and TNF-α levels in group MR at 24 and 36 hours after surgery were significantly lower (P < 0.05). There were no significant differences in the consumption of sufentanil during surgery, Δ HR, Δ MAP, and occurrences of adverse effects between the two groups.
Conclusion: Adding magnesium sulfate as an adjuvant to ropivacaine for posterior lumbar block can effectively improve the analgesic effect, reduce the use of opioids after surgery, and reduce the secretion of pro-inflammatory factors, which is beneficial for rapid postoperative recovery of patients. |
