Atçı Mustafa, Ünlügenç Hakkı, Güneş Yasemin, Burgut Refik, Işık Geylan, Hatipoğlu Zehra, Türktan Mediha
Department of Anaesthesiology, Mardin Park Hospital, Mardin, Turkey.
Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.
Turk J Anaesthesiol Reanim. 2015 Feb;43(1):13-9. doi: 10.5152/TJAR.2014.93824. Epub 2014 Sep 9.
In our study, the effect of intravenous magnesium sulphate in normal and pre-eclamptic patients on spinal anaesthesia produced by bupivacaine was investigated.
Sixty-four pregnant (32 normal and 32 pre-eclamptic) were accepted in this study. Pregnants were divided into four groups as patients given intravenous magnesium sulphate and as control. Spinal anaesthesia was induced with 12.5 mg 0.5% hyperbaric bupivacaine. Intraoperative and postoperative haemodynamic variables, sensorial block periods, onset times of sensorial and motor block, maximum sensorial block levels, the time to reach maximum block level, Bromage scores, consumptions of intraoperative analgesic and ephedrine, the quality of anaesthesia, the duration of spinal anaesthesia and magnesium levels in blood and cerebrospinal fluid were measured and recorded.
The level of magnesium in blood and cerebrospinal fluid was significantly higher in the group given magnesium in pre-eclamptic patients (p<0.01). Onset of sensory block times were significantly longer in intravenous magnesium group than in groups 1, 2 and 3 (p<0.05). Onset of motor block times were significantly longer and the duration of anaesthesia was shorter in groups given magnesium (p<0.05). Although the quality of anaesthesia was similar, supplemental analgesic consumption was significantly higher in pre-eclamptic pregnants given magnesium sulphate than in pre-eclamptic pregnants who were not given magnesium sulphate (p<0.05).
Intravenous magnesium sulphate treatment during the spinal anaesthesia produced by bupivacaine extended the onset of sensory and motor block times, shortened the duration of spinal anaesthesia and therefore led to early analgesic requirement.
在本研究中,我们调查了静脉注射硫酸镁对正常孕妇和子痫前期患者布比卡因腰麻效果的影响。
本研究纳入64例孕妇(32例正常孕妇和32例子痫前期患者)。将孕妇分为静脉注射硫酸镁组和对照组,共四组。用12.5mg 0.5%的高压布比卡因进行腰麻。测量并记录术中及术后的血流动力学变量、感觉阻滞时间、感觉和运动阻滞的起效时间、最大感觉阻滞平面、达到最大阻滞平面的时间、 Bromage评分、术中镇痛药和麻黄碱的用量、麻醉质量、腰麻持续时间以及血液和脑脊液中的镁水平。
子痫前期患者中给予硫酸镁组的血液和脑脊液中的镁水平显著更高(p<0.01)。静脉注射硫酸镁组的感觉阻滞起效时间显著长于第1、2和3组(p<0.05)。给予硫酸镁组的运动阻滞起效时间显著更长,麻醉持续时间更短(p<0.05)。尽管麻醉质量相似,但子痫前期孕妇中给予硫酸镁的患者补充镇痛药的用量显著高于未给予硫酸镁的子痫前期孕妇(p<0.05)。
在布比卡因腰麻期间静脉注射硫酸镁治疗会延长感觉和运动阻滞的起效时间,缩短腰麻持续时间,因此导致更早需要镇痛药。