[1]杜健华,袁应川,王龙.硫酸镁对腹腔镜斜疝修补术后患儿疼痛及躁动影响研究[J].麻醉安全与质控,2019,3(03):137-140.[doi:10.3969/j.issn.2096-2681.2019.03.004]
 DU Jianhua,YUAN Yingchuan,WANG Long.The efficacy of magnesium sulfate on the pain and emergence agitation in children undergoing laparoscopic inguinal hernia surgery[J].Perioperative Safety and Quality Assuance,2019,3(03):137-140.[doi:10.3969/j.issn.2096-2681.2019.03.004]
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硫酸镁对腹腔镜斜疝修补术后患儿疼痛及躁动影响研究()
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《麻醉安全与质控》[ISSN:2096-1245/CN:CN 61-1505/R]

卷:
3
期数:
2019年03期
页码:
137-140
栏目:
临床研究
出版日期:
2019-06-11

文章信息/Info

Title:
The efficacy of magnesium sulfate on the pain and emergence agitation in children undergoing laparoscopic inguinal hernia surgery
作者:
杜健华 袁应川 王龙
新疆医科大学第二附属医院麻醉科, 新疆 乌鲁木齐 830063
Author(s):
DU Jianhua YUAN Yingchuan WANG Long
Department of Anesthesiology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
关键词:
硫酸镁 术后疼痛 苏醒期躁动 腹腔镜 小儿
Keywords:
magnesium sulfate postoperative pain emergence agitation laparoscope children
DOI:
10.3969/j.issn.2096-2681.2019.03.004
摘要:
目的 观察输注硫酸镁对腹腔镜斜疝修补术后患儿疼痛及苏醒期躁动的影响。 方法 选取新疆医科大学第二附属医院2016-01/2017-01期间腹腔镜下斜疝修补术患儿100例, ASA分级Ⅰ或Ⅱ级, 年龄3~8岁, 随机分为对照组(C组, n=50), 硫酸镁组(M组, n=50)。 对照组予以等容量的生理盐水静注, M组于麻醉诱导前静脉给予硫酸镁注射液30 mg/kg(15 min滴完), 随之泵注硫酸镁注射液10 mg/(kg?h)至手术结束。 分别记录2组患儿手术时间、 出血量, 并于患儿拔管即刻(T1)、 拔管后10 min(T2)、 20 min(T3)、 30 min(T4)、 1 h(T5)、 2 h(T6), 采用FLACC法对患儿疼痛进行评估, 苏醒期躁动评分量表(PAED)对躁动情况进行评分, 并分别监测患儿手术前、 术后即刻、 术后6 h及12 h血浆镁离子浓度。 结果 两组患儿在性别、 年龄、 体质量、 手术时间及出血量方面, 差异无统计学意义(P>0.05), M组患儿在T1、 T2、 T3及T4时点FLACC评分低于C组, 差异有统计学意义(P<0.05), M组患儿在T1、 T2、 T3、 T4、 T5及T6时点PAED评分低于C组(P<0.05), M组患儿在术后即刻及术后6 h血浆镁离子浓度高于C组。 结论 围术期输注硫酸镁可以降低经腹腔镜斜疝修补术后患儿疼痛评分, 并减少苏醒期躁动的发生。
Abstract:
Objective To investigate the efficacy of magnesium sulfate on the pain and emergence agitation in children undergoing laparoscopic inguinal hernia surgery.Methods One hundred American Society of Anesthesiologists physical statusⅠor Ⅱchildren, aged 3-8 years, undergoing laparoscopic inguinal hernia surgery, in the Second Affiliated Hospital of Xinjiang Medical University from January 2016 to January 2017 were randomized divided into 2 groups (n=50 each): magnesium sulfate (group M), control group (group C). Children in group M received magnesium sulfate 30 mg/kg intravenously over 15 min before anesthesia induction and followed by continuous infusion of 10 mg/(kg?h) till the end of surgery. While children in group C received the same volume of saline.The operation time and the amount of bleeding of both groups were recorded. The FLACC score and PAED score were recorded at extubation (T1), and 10 min (T2), 20 min (T3), 30 min (T4), 1 h (T5)and 2 h (T6) after extubation. The level of magnesium in plasma was monitored before surgery, at extubation, 6 h and 12 h after surgery. Results No significant change was found in gender, age, BMI, the operation time an.d the amount of bleeding in group M (P>0.05). The FLACC score in group M were significantly lower than those in group C at T1, T2, T3 and T4.The PAED scores in group M were significantly lower than those in group C at T1, T2, T3, T4, T5 and T6(P<0.05). Serum magnesium concentrations in group M were higher until 6 h after operation than that in group C. Conclusion Intravenous infusion of magnesium sulfate can effectively alleviate the pain after operation and reduce the incidence of emergence agitation in children undergoing laparoscopic inguinal hernia surgery.

参考文献/References:

[1] SONG I A, SEO K S, OH A Y, et al. Dexmedetomidine injection during strabismus surgery reduces emergence agitation without increasing the oculocardiac reflex in children: a randomized controlled trial [J/OL]. PLoS One, 2016, 11(9): e0162785. DOI: 10.1371/journal.pone.0162785.
[2] WONG D D, BAILEY C R. Emergence delirium in children[J].Anaesthesia, 2015, 70(4): 383-387. DOI: 10.1111/anae.13043.
[3] 章晓慧, 董有静, 刘双梅. 芬太尼与舒芬太尼对儿童全麻苏醒期躁动的临床研究[J]. 国际儿科学杂志, 2017, 44(7): 498-500.
[4] HARYALCHI K, ABEDINZADE M, KHANAKI K, et al. Whether preventive low dose magnesium sulphate infusion has an influence on postoperative pain perception and the level of serum beta-endorphin throughout the total abdominal hysterectomy[J]. Rev Esp Anestesiol Reanim, 2017, 64(7): 384-390. DOI: 10.1016/j.redar.2016.11.009.
[5] RYU J H, KOO B W, KIM B G, et al. Prospective, randomized and controlled trial on magnesium sulfate administration during laparoscopic gastrectomy: effects on surgical space conditions and recovery profiles[J]. Surg Endosc, 2016, 30(11): 4976-4984.
[6] XIE M, LI X K, PENG Y. Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis[J]. J Evid Based Med, 2017, 10(1): 16-25. DOI: 10.1111/jebm.12230.
[7] CHO H K, PARK I J, YOON H Y, et al. Efficacy of adjuvant magnesium for posttonsillectomy morbidity in children: a meta-analysis[J]. Otolaryngol Head Neck Surg, 2018, 158(1): 27-35. DOI: 10.1177/0194599817730354.
[8] 裴灏, 王炫. 硫酸镁对小儿阑尾手术术后镇痛的影响[J]. 中国临床医学, 2015, 22(5): 676-678.
[9] 连庆泉, 张马忠, 胡智勇, 等. 小儿麻醉手册[M]. 2版. 上海: 上海世界图书出版公司, 2017: 208.
[10] 胡柳青, 魏国华, 鲁婷. 硫酸镁减轻喉罩全麻后咽喉痛的临床观察[J]. 齐齐哈尔医学院学报, 2017, 38(17): 2042-2043.
[11] ABDULATIF M, AHMED A, MUKHTAR A, et al. The effect of magnesium sulphate infusion on the incidence and severity of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia[J]. Anaesthesia, 2013, 68(10): 1045-1052. DOI: 10.1111/anae.12380.
[12] GIBERT S, SABOURDIN N, LOUVET N, et al. Epileptogenic effect of sevoflurane: determination of the minimal alveolar concentration of sevoflurane associated with major epileptoid signs in children[J]. Anesthesiology, 2012, 117(6): 1253-1261. DOI: 10.1097/ALN.0b013e318273e272.
[13] VLAJKOVIC G P, SINDJELIC R P. Emergence delirium in children: many questions, few answers[J]. Anesth Analg, 2007, 104(1): 84-91.
[14] FAWCETT W J, HAXBY E J, MALE D A. Magnesium: physiology and pharmacology[J]. Br J Anaesth, 1999, 83(2): 302-320.

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备注/Memo

备注/Memo:
收稿日期: 2019-02-10; 接受日期: 2019-04-22
基金项目: 新疆维吾尔自治区自然科学基金(2018D01C238)
作者简介: 杜建华, 副主任医师, 硕士, E-mail: dujianhua12a@163.com
通信作者: 杜健华, E-mail: dujianhua12a@163.com
更新日期/Last Update: 2019-06-15