南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (12): 1650-.

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硫酸镁对食道癌根治术患者全麻苏醒期躁动的影响

谢敏，李祥奎，陈杰   

  • 出版日期:2016-12-20 发布日期:2016-12-20

Effect of magnesium sulphate infusion on emergence agitation in patients undergoing esophageal carcinoma with general anesthesia: a randomized, double-blind, controlled trial

  • Online:2016-12-20 Published:2016-12-20

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摘要： 目的观察硫酸镁用于食道癌根治术患者全麻苏醒期躁动的有效性及安全性。方法采用随机双盲对照设计，2015年10 月~2016年3月行择期食道癌根治术的全麻患者，随机分为硫酸镁组（试验组）和生理盐水组（对照组）。所有患者均采用全凭静 脉麻醉，诱导结束后，硫酸镁组以0.1 mL/（kg·h）（2.5 g硫酸镁加入50 mL生理盐水,泵注速度为5 mg/（kg·h））持续泵注硫酸镁， 而对照组以相同的速度持续泵注生理盐水，直至手术结束。记录患者躁动，疼痛，肌张力评分，拔管时间，恢复室停留时间以及 术后不良反应，术后Mg2+，Ca2+，K+浓度。采用SPSS17.0软件进行统计分析。结果共纳入108例患者，其中硫酸镁组57例，对照 组51例。硫酸镁组在恢复室（PACU）的躁动评分、疼痛评分、肌张力评分明显低于对照组，停药后拔管时间明显长于对照组（P< 0.05）。两组患者术前Ca2+浓度明显高于术后，且对照组术前Mg2+浓度明显高于术后，硫酸镁组术后Mg2+浓度明显高于对照组术 后（P<0.05）。硫酸镁组术前及术后Mg2+浓度无明显差异（P>0.05）。两组在PACU停留时间、入PACU即时苏醒期躁动评分,术 前术后K+浓度差异均无统计学意义（P>0.05）。结论食道癌根治术中泵注5 mg/（kg.h）硫酸镁，能明显减少患者苏醒期躁动的 发生且不会出现肌力恢复延迟，电解质紊乱等并发症。

Abstract: Objective To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. Methods This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People’s Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0.1 mL·kg-1·h-1 (2.5 g magnesium sulphate in 50 ml saline pumped at 5 mg·kg-1·h-1) or saline (control group) at the same speed until the end of the surgery. The Riker’s sedation agitation scale, pain score, muscle tension score, extubation time, residence time in the postanesthesia care unit (PACU), and adverse reactions were recorded. Results A total of 108 patients were enrolled including 57 in magnesium sulphate group and 51 in the control group. Riker’s sedation agitation scale in the PACU, pain score, and muscle tension score were all significantly lower but the extubation time was longer in magnesium sulphate group than in the control group (P<0.05). In all the patients, blood Ca2 + level was reduced significantly after the operation; blood Mg2 + level was significantly lowered postoperatively in the control group, and the postoperative Mg2+ level was significantly higher in magnesium sulphate group than in the control group (P<0.05). Mg2+ level underwent no significant variations in magnesium sulphate group after the operation (P>0.05). The residence time in the PACU, postoperative Riker’s sedation agitation scale score, and blood K+ level were all similar between the two groups(P>0.05). Conclusion Infusion of magnesium sulphate at 5 mg·kg-1 ·h-1 can significantly reduce the incidence of emergence agitation in patients undergoing esophageal carcinoma under general anesthesia without causing such complications such as muscle recovery delay or electrolyte disorder.