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骨科手术中的镇痛考量:硫酸镁输注的作用

Analgesia considerations in orthopaedic surgery: the role of magnesium sulfate infusions.

作者信息

Papadimos Thomas J, Pappada Scott M, Alexander Jacob, Altsitzioglou Pavlos, Saranteas Theodosis, Lustig Sebastien, Mavrogenis Andreas F

机构信息

Department of Anesthesiology, Surgery, and Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, OH 43606-3390, USA.

Department of Anesthesiology, University of Toledo College of Medicine and Life Sciences, Toledo, OH 43606-3390, USA.

出版信息

SICOT J. 2025;11:E1. doi: 10.1051/sicotj/2025030. Epub 2025 Jun 6.

Abstract

Orthopaedic surgical operations are associated with significant post-operative pain, often managed with opioids, which carry risks of adverse effects and dependency. Magnesium sulfate, a NMDA receptor antagonist with analgesic and muscle relaxant properties, has emerged as a potential adjunct to improve pain control and reduce opioid consumption in orthopaedic procedures. Current evidence supports magnesium sulfate as a valuable adjunct in orthopaedic pain management, particularly in reducing opioid consumption and enhancing muscle relaxation. However, heterogeneity in study design, administration protocols, and patient populations warrants cautious interpretation. Monitoring for side effects such as hypotension and respiratory depression remains essential. Further high-quality, standardized trials are needed to optimize dosing strategies and confirm long-term benefits.

摘要

骨科手术会带来严重的术后疼痛,通常使用阿片类药物进行管理,但这类药物存在副作用和成瘾风险。硫酸镁是一种具有镇痛和肌肉松弛特性的N-甲基-D-天冬氨酸(NMDA)受体拮抗剂,已成为一种潜在的辅助药物,可改善骨科手术中的疼痛控制并减少阿片类药物的使用。目前的证据支持硫酸镁作为骨科疼痛管理中有价值的辅助药物,特别是在减少阿片类药物使用和增强肌肉松弛方面。然而,研究设计、给药方案和患者群体的异质性需要谨慎解读。监测低血压和呼吸抑制等副作用仍然至关重要。需要进一步开展高质量、标准化的试验,以优化给药策略并确认长期益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f09/12143129/bcfaec747acf/sicotj-11-E1-fig1.jpg

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