硫酸镁静脉输注对下肢骨折内固定术后芬太尼用量的影响

目的:观察静脉输注硫酸镁对下肢骨折内固定术后芬太尼用量的影响。方法:46例ASAⅠ~Ⅱ级择期在连续硬膜外麻醉下行下肢骨折内固定的病人,随机分为输注硫酸镁组(MG组)和对照组(NS组)两组,各23例。MG组麻醉前给负荷剂量25%MgSO425mg/kg,继以200mg/h持续输注48h。NS组给相同体积的生理盐水。于术后4(T1)、8(T2)、18(T3)、24(T4)、48h(T5)记录病人视觉模拟评分(VAS)和PCIA泵中芬太尼的需求量,记录PCIA的不良反应。结果:两组病人镇痛效果均满意,VAS评分T3时MG组低于NS组(P<0.05);PCIA中芬太尼的总需求量MG组显著低于NS组(P<0.01)。结论:静脉输注硫酸镁可减少术后芬太尼的需求量、降低不良反应及提高病人的早期舒适度。

Effects of Infusing Magnesium Sulfate Intravenously on Fentanyl Demanding after Interal Fixation Treated with Lower Limb Fracture

Objective:To observe effects of magnesium sulfate(MgSO4)on the fentanyl requiement after interal fixation treated with lower limb fracture.Methods:46 ASA Ⅰ~Ⅱadult patients undergoing selective after interal fixation treated with lower limb fracture and epidural anesthesia were randomly divided into 2 groups :Group 1[normal saline group(NS),n=23],Group 2[magnesium group(MG),n=23].The patients in group MG received 25% magnesium sulfate 25mg/kg intravenously before start of surgery and 200mg/h for the next 48h.The patients in group NS received the same volume of saline,at 4(T1),8(T2),18(T3),24(T4)and 48h(T5)during postoperative period,VAS and fentanyl consumption were recorded.The complications of PCIA were recorded.Results:All patients were satisfied with PICA.At T3 the VAS was lower in group MG than that in group NS(P<0.05);Fentanyl consumption was significantly lower in group MG than those in group NS in 48h PCIA(P<0.01).Conclusion:Continuous intravenous infusion of MgSO4 attenuates postoperative pain,the total dosage of fentanyl reduced and side-effects declined.