■为了全面了解术中输注硫酸镁对正颌手术患者的影响,包括瑞芬太尼的消费,术后疼痛,术后恶心和呕吐(PONV),炎症反应,和血清镁水平.
■将75例成年患者在全身平衡麻醉下进行正颌手术随机分为两组。一组(M组)插管后接受20mL0.9%生理盐水中的50mg/kg硫酸镁,然后以15mg/kg/h的速度连续输注,直到预期手术结束前30分钟。另一组(C组)接受等体积的等渗盐水作为安慰剂。(临床试验登记号:chiCTR2100045981)。
■主要结果是瑞芬太尼的消耗。次要结果包括使用口头数字评定量表(VNRS)评估的疼痛评分和使用Likert量表评估的PONV。M组的瑞芬太尼消耗低于C组(平均值±SD:0.146±0.04μg/kg/minvs.0.173±0.04μg/kg/min,P=0.003)。手术后2小时,C组患者的PONV比M组患者严重(中位数[四分位距,IQR]:1[3]vs.1[0],平均排名:31.45vs.42.71,P=0.040)。在麻醉后监护病房(PACU),C组术后疼痛比M组严重(3[1]vs.3[0],平均排名:31.45vs.42.71,P=0.013)。两组间血流动力学和手术野评分变化无差异(均P>0.05)。细胞因子(IL-4,IL-6,IL-8,IL-10,TNF-a,MIP-1β)术后各组间差异无统计学意义(均P>0.05)。C组术后血清镁水平低于M组(0.74±0.07mmol/Lvs.0.91±0.08mmol/L,P=0.000)和术前水平(0.74±0.07mmol/Lvs.0.83±0.06mmol/L,P=0.219)。
■在正颌手术中,硫酸镁可以减少瑞芬太尼的需求,减轻术后早期的PONV和术后疼痛。
UNASSIGNED: To comprehensively understand the effects of intra-operative infusion of magnesium sulfate on patients who underwent orthognathic surgery, including remifentanil consumption, postoperative pain, postoperative nausea and vomiting (PONV), inflammatory response, and serum magnesium levels.
UNASSIGNED: Seventy-five adult patients undergoing orthognathic surgery under general balanced anesthesia were randomly divided into two groups. One group (Group M) received 50 mg/kg of magnesium sulfate in 20 mL 0.9 % saline after intubation, followed by a continuous infusion at a rate of 15 mg/kg/h until 30 min before the anticipated end of surgery. The other group (Group C) received an equal volume of isotonic saline as a placebo. (Clinical
trial registration number: chiCTR2100045981).
UNASSIGNED: The primary outcome was remifentanil consumption. The secondary outcomes included the pain score assessed using the verbal numerical rating scale (VNRS) and PONV assessed using a Likert scale. Remifentanil comsumption in Group M was lower than Group C (mean ± SD: 0.146 ± 0.04 μg/kg/min vs. 0.173 ± 0.04 μg/kg/min, P = 0.003). At 2 h after surgery, patients in Group C suffered more severe PONV than those in Group M (median [interquartile range, IQR]: 1 [3] vs. 1 [0], mean rank: 31.45 vs. 42.71, P = 0.040). At post-anesthesia care unit (PACU), postoperative pain in Group C was severe than Group M (3 [1] vs. 3 [0], mean rank: 31.45 vs. 42.71, P = 0.013). Changes in haemodynamics and surgical field scores did not differ between the groups (all P > 0.05). The levels of cytokines (IL-4, IL-6, IL-8, IL-10, TNF-a, and MIP-1β) were not significantly different between the groups after surgery (all P > 0.05). Postoperative serum magnesium levels in Group C were lower than those in Group M (0.74 ± 0.07 mmol/L vs. 0.91 ± 0.08 mmol/L, P = 0.000) and the preoperative level (0.74 ± 0.07 mmol/L vs. 0.83 ± 0.06 mmol/L, P = 0.219).
UNASSIGNED: In orthognathic surgery, magnesium sulfate administration can reduce remifentanil requirement and relieve PONV and postoperative pain in the early postoperative phase.