术中静脉注射硫酸镁对异丙酚和瑞芬太尼用药量与术后不良事.docVIP

术中静脉注射硫酸镁对异丙酚和瑞芬太尼用药量及术后不良事件的影响 陈 巍1△，胡永初1△，田谋利 1*，汪志平2* 第二军医大学长征医院麻醉科，上海 200003 ， [作者简介]陈巍，学士，住院医生E-mail：123494311@; 胡永初，学士，医生。E-mail：△共同第一作者（Co-first authors） *通讯作者（Coresponding authors）. Tel:021E-mail：tianml1973@Tel:0574 E-mail： [摘要] 目的 评价麻醉诱导后静脉注射50mg/kg硫酸镁对患者术中异丙酚及瑞芬太尼用量及术后不良反应的影响。方法 选取择期全麻下行颅脑手术，美国麻醉师协会（American Society of Anesthesiologists，ASA）分级或级的成年患者60例（18-60岁），性别不限，随机分为2 组（n=30）：对照组（C组）和硫酸镁组（T组）。T组于诱导后即予静脉注射50mg/kg硫酸镁，C组予生理盐水。术前、术后检测血镁浓度。记录术中异丙酚、瑞芬太尼的用药量疼痛、恶心呕吐、肌张力及腱反射等不良事件发生情况。 结果 术中异丙酚及瑞芬太尼的用量（P0.05）并可明显降低术后疼痛（P0.05）恶心呕吐、肌张力及腱反射等术后不良事件发生术后血镁浓度明显（P0.05）。结论 术中静脉注射硫酸镁50mg/kg)可有效减少术中异丙酚及瑞芬太尼用量，并可有效减低术后疼痛，且对术后不良事件发生无明显影响。 [关键词]硫酸镁；异丙酚；瑞芬太尼；不良事件 [中图分类号] R 614.2+1 [文献标志码] A [Abstract] Objective Evaluation the effect of intraoperative intravenous magnesium sulfate on propofol , fentanyl dose and postoperative adverse events. Methods Sixty ASA I or patients of either sex，aged18-60 yrs.，undergoing craniocerebral surgery with general anesthesia were randomly divided into 2 groups(n=30 each)：control group(group C)and magnesium sulfate group(group T)．T group received intravenous 50 mg/kg magnesium sulfate after the induction, while C group received normal saline. Blood concentration of magnesium was measured before and after operation. The dose of intraoperative propofol and fentanyl, and the incidence of postoperative pain, nausea and vomiting, muscle tension and tendon reflex and other adverse events at different time were recorded. Results Intraoperative intravenous magnesium sulfate can effectively reduce the intraoperative propofol and fentanyl dosage（P0.05）, and alleviate postoperation pain（P0.05）. While, there was no obvious change in adverse events, such as Nausea and vomiting, muscle tension and tendon reflex, and postoperative blood concentration of magnesium（P0.05）. Conclusion Intraoperative intravenous magnesium sulfate (50 mg/kg) can effectively reduce the intraoperative propofol and fentanyl dosage, and can effe