【摘要】 目的比较小剂量硫酸镁联合舒芬太尼与单纯舒芬太尼术后静脉镇痛的临床效应.方法选择行胃肠道手术后患者60例,随机均分为二组,每组30例,以一次性静脉镇痛泵(2ml/h)分别行静脉术后镇痛,S组:单纯舒芬太尼镇痛,2μg/kg舒芬太尼+3mg格拉司琼,MS组:硫酸镁联合舒芬太尼镇痛,2μg/kg舒芬太尼+50mg/kg硫酸镁+3mg格拉司琼,各组镇痛泵中药物均用生理盐水稀释至100ml,观察各组患者镇痛48 h内的静息镇痛评分(VAS方法),恶心呕吐,皮肤瘙痒和尿潴留的发生情况,术后血清镁离子和钙离子的浓度变化情况.结果二组患者的静息镇痛评分在MS组明显低于S组(P<0.05),恶心呕吐发生率MS组显著低于S组(P<0.01).两组患者血清中钙离子浓度差异无统计学意义(P>0.05).两组患者血清镁离子浓度减少有统计学意义(P<0.05).结论小剂量硫酸镁用于术后静脉镇痛可明显减少舒芬太尼的剂量,使恶心呕吐等不良反应发生率降低,镇痛效果明显优于单纯舒芬太尼术后静脉镇痛,且可改善术后镁离子浓度下降的程度.表3,参9.更多还原

【Abstract】 Objective To compare clinical effects of postoperative analgesia by composition of the low dose of magnesium sulfate with sufentanil and by sufentanil alone.Methods 60 patients under gastrointestinal surgery were randomly divided into two groups.Each group had 30 patients which were intravenous analgesia with single intravenous analgesia pump(2 ml/h).S Group: treated with Shu Fen Tai Nepal analgesia only,2μg/kg sufentanil + 3 mg granisetron.MS Group: treated with magnesium sulfate and sufentanil analgesia,2μg / kg sufentanil + 50 mg / kg magnesium sulfate + 3 mg granisetron.The drug analgesia pump were diluted with a medical saline to 100 ml and resting pain score(VAS method),nausea and vomiting,pruritus and the incidence of urinary retention were observed within 48 h in each group.Results resting pain score in the MS group was markedly lower than S group(P<0.05),nausea and vomiting in MS group was significantly lower than S group(P<0.01).Magnesium and calcium ion concentration in serum were observed after gastrointestinal surgery.Conclusion intravenous administration of low dose magnesium sulfate for postoperative analgesia could significantly reduce the dose of sufentanil and lower the incidence of adverse reactions including nausea and vomiting.Moreover,its analgesic effect was better than intravenous sufentanil alone in postoperative analgesia.In addition,it could inhibit the degree of concentration of magnesium ions declined in the postoperative analgesia.3tabs.,9refs.更多还原