硫酸镁对脊柱侧凸矫形手术唤醒试验的影响

Effects of magnesium sulphate on wake-up test in scoliosis surgery

目的评价硫酸镁对脊柱侧凸矫形手术唤醒试验的影响。方法行脊柱侧弯矫形手术患．者50名，年龄10～25岁，ASA分级Ⅰ～Ⅱ级，随机分为2组，每组25例：R组（术中持续以0．4μg／（k·min）速率输注雷米芬太尼）；M组（术中持续以0．4μg／（kg·min）速率输注雷米芬太尼，并在诱导前给予硫酸镁40mg／（kg·min）静脉滴注，继以20mg／（kg·h）的速率持续输注至术毕）。唤醒前约20min停用七氟醚。从停用所有麻醉药到病人动脚趾的时间记为唤醒时间，并记录唤醒质量、唤醒时的心率和平均动脉压、气管拔管时间及不良反应的发生率。结果2组间的唤醒时间、质量、拔管时间和不良反应发生率差异无统计学意义。M组病人唤醒时的心率并口．平＇均动脉压明显低于R组（P〈0．05）。结论脊柱侧凸矫形术中辅助使用硫酸镁，负荷剂量40mg／kg，继以20mg／（k·h）静脉输注，不影响唤醒的时间和质量、拔管时间及不良反应的发生率并可稳定唤醒时的血流动力．学。

Objective To evaluate the effects of magnesium sulphate on wake-up test in scoliosis surgery. Methods Fifty patients scheduled for posterior scoliosis correction （ASA ≯- Ⅱ, aged 10-25 years）,were randomly divided into two groups （ n = 25） ： Group R [ intraoperative remifentanil at 0.4 μg/（kg· min） ] ; Groμp M [ intraoperative remifentanil at 0.4μg/（kg·min）, accompanied with induction dose of 40 mg/kg magnesium sulphate, followed by an intraoperative infusion of 20 mg/（kg·h） till the end of the surgery]. Sevoflurane was discontinued about 20 min before the wake-up test. The wake up time from all the anaesthetic discontinuation to movement of the patient＇s toe and quality were recorded. The mean arterial pressure and heart rate in wake-up test, extuhation time and side effects were also recorded. Results There were no significant differences between the two groups in wake-up time and quality, extuhation time and side effects, P 〉0.05. In wake-up test, the mean arterial pressure and heart rate in Group M were lower than those in Group R, P 〈 0.05. Conclusions Preoperative magnesium sulphate supplementation could stabilize hemodynamics in wake-up test but has no effect on wake-up time and quality, extubation time and side effects in scoliosis surgery.