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Abstract：
BACKGROUND: Over the last two decades, a large body of literature has focused on studying the prevalence and outcome of the postoperative delirium and sleep disturbance. The aim of this work was to evaluate the effect of intraoperative administration of Magnesium sulphate on the occurrence of post-operative delirium and insomnia in patients undergoing lumbar fixation.
METHODS: This prospective randomized controlled trial was carried out on 80 patients indicated for lumbar fixation; 40 of them received conventional general anesthesia with extra administration of intraoperative magnesium sulphate (Mg sulphate group), and the other 40 received conventional general anesthesia only (control group). Both groups were submitted to pre-operative assessment of depression using Beck Depression inventory (BDI) scale, pre-operative assessment of fatigue using a fatigue questionnaire, pre- and post-operative assessment of insomnia using Insomnia severity index (ISI), post-operative assessment of delirium using Memorial delirium assessment scale (MDAS), post-operative assessment of pain using Visual Analogue Scale (VAS), and pre- and post-operative Quantitative electroencephalography (QEEG).
RESULTS: Mg sulphate administration, age, pre-operative BDI, pre-operative ISI, and post-operative VAS were independent predictors of post-operative ISI (P-value < 0.001, 0.047, 0.021, < 0.001, and < 0.001 respectively). Age and post-operative VAS were independent predictors of post-operative MDAS (P-value = 0.008, 0.013 respectively). Mg sulphate administration and pre-operative ISI were independent predictors of post-operative VAS (P-value = 0.010, 0.006 respectively).
CONCLUSIONS: There was a significant relationship between intraoperative Mg sulphate administration and both post-operative insomnia and pain in unadjusted and adjusted analysis.
METHODS: This prospective randomized controlled trial was carried out on 80 patients indicated for lumbar fixation; 40 of them received conventional general anesthesia with extra administration of intraoperative magnesium sulphate (Mg sulphate group), and the other 40 received conventional general anesthesia only (control group). Both groups were submitted to pre-operative assessment of depression using Beck Depression inventory (BDI) scale, pre-operative assessment of fatigue using a fatigue questionnaire, pre- and post-operative assessment of insomnia using Insomnia severity index (ISI), post-operative assessment of delirium using Memorial delirium assessment scale (MDAS), post-operative assessment of pain using Visual Analogue Scale (VAS), and pre- and post-operative Quantitative electroencephalography (QEEG).
RESULTS: Mg sulphate administration, age, pre-operative BDI, pre-operative ISI, and post-operative VAS were independent predictors of post-operative ISI (P-value < 0.001, 0.047, 0.021, < 0.001, and < 0.001 respectively). Age and post-operative VAS were independent predictors of post-operative MDAS (P-value = 0.008, 0.013 respectively). Mg sulphate administration and pre-operative ISI were independent predictors of post-operative VAS (P-value = 0.010, 0.006 respectively).
CONCLUSIONS: There was a significant relationship between intraoperative Mg sulphate administration and both post-operative insomnia and pain in unadjusted and adjusted analysis.
摘要：
背景：在过去的二十年里，大量文献集中在研究术后谵妄和睡眠障碍的患病率和结果。这项工作的目的是评估术中施用硫酸镁对腰椎固定术患者术后谵妄和失眠发生的影响。
方法：这项前瞻性随机对照试验是对80例腰椎固定术患者进行的；其中40例接受常规全身麻醉，术中额外给予硫酸镁（硫酸镁组），其余40例仅接受常规全身麻醉（对照组）。两组均采用贝克抑郁量表(BDI)进行术前抑郁评估,使用疲劳问卷进行术前疲劳评估，使用失眠严重程度指数（ISI）评估术前和术后失眠，使用纪念谵妄评估量表（MDAS）评估谵妄术后，使用视觉模拟评分（VAS）评估术后疼痛，术前和术后定量脑电图（QEEG）。
结果：硫酸镁给药，年龄,术前BDI,术前ISI,和术后VAS是术后ISI的独立预测因子(P值分别<0.001、0.047、0.021、<0.001和<0.001)。年龄和术后VAS是术后MDAS的独立预测因素(P值分别为0.008、0.013)。硫酸镁给药和术前ISI是术后VAS的独立预测因素（P值分别为0.010，0.006）。
结论：在未经调整和调整的分析中，术中使用硫酸镁与术后失眠和疼痛之间存在显著关系。
方法：这项前瞻性随机对照试验是对80例腰椎固定术患者进行的；其中40例接受常规全身麻醉，术中额外给予硫酸镁（硫酸镁组），其余40例仅接受常规全身麻醉（对照组）。两组均采用贝克抑郁量表(BDI)进行术前抑郁评估,使用疲劳问卷进行术前疲劳评估，使用失眠严重程度指数（ISI）评估术前和术后失眠，使用纪念谵妄评估量表（MDAS）评估谵妄术后，使用视觉模拟评分（VAS）评估术后疼痛，术前和术后定量脑电图（QEEG）。
结果：硫酸镁给药，年龄,术前BDI,术前ISI,和术后VAS是术后ISI的独立预测因子(P值分别<0.001、0.047、0.021、<0.001和<0.001)。年龄和术后VAS是术后MDAS的独立预测因素(P值分别为0.008、0.013)。硫酸镁给药和术前ISI是术后VAS的独立预测因素（P值分别为0.010，0.006）。
结论：在未经调整和调整的分析中，术中使用硫酸镁与术后失眠和疼痛之间存在显著关系。
