静脉注射硫酸镁对瑞芬太尼致妇科腔镜手术患者术后痛觉过敏的影响

【目的】观察静脉注射硫酸镁对瑞芬太尼致妇科腔镜手术患者术后痛觉过敏的影响。【方法】择期行妇科腔镜手术患者56例，ASAI～Ⅱ级，随机分为A组和B组，每组28例。B组诱导前5min静脉注射硫酸镁40mg／kg，并以10mg／（kg·h）的速度输注至手术结束，A组输入等剂量生理盐水。维持麻醉：瑞芬太尼0．4μg／（kg·min），丙泊酚4mg／（kg·h）。记录术后30rain、1h、4h、12h、24hVAS评分，24h内追加芬太尼的量及不良反应的情况。【结果】A组患者术后30min至4h之间的VAS评分明显高于B组（P〈0．05）；A组停瑞芬太尼后第一次应用芬太尼的时间比B组明显提前（P〈0．05），且术后24h应用芬太尼的总量也明显较多（P〈0．05）。A组术后不良反应的发生率也高于B组（P〈0．05）。【结论】硫酸镁可以缓解瑞芬太尼．致妇科腔镛丰来患者未后痛觉过敏。

Effect of Intravenous Magnesium Sulfate on Postoperative Hyperalgesia Caused by Remifentanil in Patients Undergoing Gynecological Laparoscopic Surgery

Objective]To observe the effect of intravenous magnesium sulfate on postoperative hyperalgesia caused by remifentanil in patients undergoing gynecologic laparoscopic surgery. Methods] Totally 56 ASA Ⅰ-Ⅱ patients undergoing elective gynecological laparoscopic surgery were randomly divided into group A and group B with 28 cases in each group. Group 13 was infused with 40mg/kg magnesium sulfate intravenously 5min before the induction and then continuously infused by the velocity of 10mg/kg/h until the end of surgery. Group A was infused with equal dose of normal saline. Remifentanil 0.4μg/kg/min and propofol 4mg/kg/h were used to maintain anesthesia. VAS score at 30min, lh, 4h, 12h and 24h after operation, the additional amount of fentanyl within 24h and adverse reactions were recorded. Results] VAS score from 30min to 4h in group A after operation was significantly higher than that in group B（ P〈0.05）. The first time of fentanyl used in group A after stopping remifentanil was significantly earlier than that in group B（ P〈0.05）, and the total amount of fentanyl 24h after operation obviously increased（ P〈0.05）. The incidence of postoperative adverse reactions in group A was also higher that in group B（ P〈0. 05）. Conclusion] Magnesium sulfate can alleviate postoperative hyperalgesia induced by remifentanil in patients undergoing gynecologic laparoscopic surgery.