Abstract：
OBJECTIVE: To compare the effects of magnesium sulphate on the total dose of intravenous morphine consumption postoperatively following limb amputations along with rescue analgesia requirement, pain scores and side effects.
METHODS: This prospective, triple-blinded, randomised controlled study was conducted from October 2021 to May 2022 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised of patients scheduled for limb amputations. They were randomised into 2 equal groups. The anaesthesia protocol was uniform for all patients. Intervention group A was administered 30mg/kg loading dose and 10mg/kg/hr maintenance dose of magnesium sulphate intravenously, while patients in control group B received the same amount of plain isotonic saline. Morphine consumption, including that used for rescue analgesia and patient-controlled analgesia, was measured for 24 hours postoperatively. Numeric rating scale was used for the evaluation of postoperative pain in both groups at 15min, 1h, 2h, at discharge from the post-anaesthesia care unit and at 12h and 24h in the ward. Data was analysed using SPSS 23.
RESULTS: Of the 24 patients enrolled, the study was completed by 20(83.33%). There were 10(50%) patients in group A; 8(40%) males and 2(20%) females with mean age 24.8±14.14 years and mean surgery time 130.5±47.86 minutes. There were 10(50%) patients in group B; 8(40%) males and 2(20%) females with mean age 23.2±7.4 years and mean surgery time 117±23.85 minutes (p>0.05). Total morphine used over 24 hours in group A was 16±3.1 mg compared to 29.6±11.2 mg in group B (p<0.05). The time for first use of patient-controlled analgesia after arriving in the postanaesthesia care unit was significantly delayed in group A (72.2±24.95 minutes) compared to that in group B (25±26.68 minutes) (p<0.05). Pain scores were significantly higher in the group B at 15min compared to group A (p<0.05), but not at the rest of the time points (p>0.05).
CONCLUSIONS: Intravenous magnesium sulphate proved to be effective in lowering postoperative opioid requirement following limb amputations.
METHODS: This prospective, triple-blinded, randomised controlled study was conducted from October 2021 to May 2022 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised of patients scheduled for limb amputations. They were randomised into 2 equal groups. The anaesthesia protocol was uniform for all patients. Intervention group A was administered 30mg/kg loading dose and 10mg/kg/hr maintenance dose of magnesium sulphate intravenously, while patients in control group B received the same amount of plain isotonic saline. Morphine consumption, including that used for rescue analgesia and patient-controlled analgesia, was measured for 24 hours postoperatively. Numeric rating scale was used for the evaluation of postoperative pain in both groups at 15min, 1h, 2h, at discharge from the post-anaesthesia care unit and at 12h and 24h in the ward. Data was analysed using SPSS 23.
RESULTS: Of the 24 patients enrolled, the study was completed by 20(83.33%). There were 10(50%) patients in group A; 8(40%) males and 2(20%) females with mean age 24.8±14.14 years and mean surgery time 130.5±47.86 minutes. There were 10(50%) patients in group B; 8(40%) males and 2(20%) females with mean age 23.2±7.4 years and mean surgery time 117±23.85 minutes (p>0.05). Total morphine used over 24 hours in group A was 16±3.1 mg compared to 29.6±11.2 mg in group B (p<0.05). The time for first use of patient-controlled analgesia after arriving in the postanaesthesia care unit was significantly delayed in group A (72.2±24.95 minutes) compared to that in group B (25±26.68 minutes) (p<0.05). Pain scores were significantly higher in the group B at 15min compared to group A (p<0.05), but not at the rest of the time points (p>0.05).
CONCLUSIONS: Intravenous magnesium sulphate proved to be effective in lowering postoperative opioid requirement following limb amputations.
摘要：
目的：比较硫酸镁对肢体截肢术后静脉注射吗啡总剂量的影响以及对抢救镇痛的要求。疼痛评分和副作用。
方法：这种前瞻性，三盲，随机对照研究于2021年10月至2022年5月在ShaukatKhanum纪念癌症医院和研究中心进行，拉合尔,巴基斯坦,由计划截肢的病人组成。他们被随机分为2组。所有患者的麻醉方案是统一的。干预A组静脉给予30mg/kg负荷剂量和10mg/kg/hr维持剂量的硫酸镁,而对照组B患者接受等量的普通等渗盐水。吗啡消耗,包括用于抢救镇痛和病人自控镇痛，术后24小时测量。采用数值评定量表对两组患者术后15min疼痛进行评价,1h,2h,从麻醉后护理室出院时以及在病房的12h和24h。数据采用SPSS23进行分析。
结果：在24名患者中，20人(83.33%)完成研究.A组患者10例（50％）；男性8例（40％），女性2例（20％），平均年龄24.8±14.14岁，平均手术时间130.5±47.86分钟。B组患者10例（50％）；男性8例（40％），女性2例（20％），平均年龄23.2±7.4岁，平均手术时间117±23.85分钟（p>0.05）。A组24小时内使用的总吗啡为16±3.1mg，而B组为29.6±11.2mg（p<0.05）。与B组（25±26.68分钟）相比，A组到达麻醉后首次使用患者自控镇痛的时间（72.2±24.95分钟）明显延迟（p<0.05）。15min时B组疼痛评分明显高于A组(p<0.05),但在其余时间点没有（p>0.05）。
结论：静脉硫酸镁被证明可有效降低截肢术后阿片类药物的需求。
方法：这种前瞻性，三盲，随机对照研究于2021年10月至2022年5月在ShaukatKhanum纪念癌症医院和研究中心进行，拉合尔,巴基斯坦,由计划截肢的病人组成。他们被随机分为2组。所有患者的麻醉方案是统一的。干预A组静脉给予30mg/kg负荷剂量和10mg/kg/hr维持剂量的硫酸镁,而对照组B患者接受等量的普通等渗盐水。吗啡消耗,包括用于抢救镇痛和病人自控镇痛，术后24小时测量。采用数值评定量表对两组患者术后15min疼痛进行评价,1h,2h,从麻醉后护理室出院时以及在病房的12h和24h。数据采用SPSS23进行分析。
结果：在24名患者中，20人(83.33%)完成研究.A组患者10例（50％）；男性8例（40％），女性2例（20％），平均年龄24.8±14.14岁，平均手术时间130.5±47.86分钟。B组患者10例（50％）；男性8例（40％），女性2例（20％），平均年龄23.2±7.4岁，平均手术时间117±23.85分钟（p>0.05）。A组24小时内使用的总吗啡为16±3.1mg，而B组为29.6±11.2mg（p<0.05）。与B组（25±26.68分钟）相比，A组到达麻醉后首次使用患者自控镇痛的时间（72.2±24.95分钟）明显延迟（p<0.05）。15min时B组疼痛评分明显高于A组(p<0.05),但在其余时间点没有（p>0.05）。
结论：静脉硫酸镁被证明可有效降低截肢术后阿片类药物的需求。
