硫酸镁在妇科开腹子宫全切术术后镇痛中的应用效果研究

Magnesium Sulphate in Post-operative Pain Relief after Hysterectomy: A Study of Application Effects

目的探讨硫酸镁对妇科开腹手术患者的术后镇痛效果。方法将2011年7月至2012年5月在温州市鹿城区人民医院诊断为子宫肌瘤并择期行开腹子宫全切术的患者60例,随机分为两组,每组各30例。硫酸镁组关腹前给予硬膜外500μg硫酸镁及1 mg吗啡,对照组给予1 mg吗啡,观察两组术后2 h、4 h、8 h、16 h和24 h的疼痛评分及并发症,比较两组患者入室、术毕、术后4 h、24 h血浆β内啡肽水平和首次需要镇痛时间。结果硫酸镁组患者24小时内各时点的疼痛评分、术后4、24 h的β内啡肽水平、首次需要镇痛时间均明显优于对照组。结论硬膜外给予硫酸镁复合吗啡较单用吗啡可安全有效地改善子宫肌瘤开腹子宫全切术患者的术后镇痛效果。

Objective To explore the effects of postoperative magnesium sulphate on pain relief after open gyneco- logical surgery. Methods Sixty women who were diagnosed as hysteromyoma in Lucheng People＇ Hospital in Wenzhou city and underwent open hysterectomy from July 2011 to May 2012 were randomly divided into two groups （30 women in each group）. Applying epidural administration of magnesium sulfate, the magnesium sulfate group （n=30） was given 500 Hg magnesium sulfate and 1 mg morphine, while the control group （n=30） was only given 1 mg morphine. Pain scores （at 2 h, 4 h, 8 h, 16 h and 24 h, respectively） as well as complications were observed. Plasma levels of β-endorphin （β-EP） （in 4 h and 24 h, respectively） and the first time when needs postoperative analgesia were recorded. Results Compared with the control group, pain scores during 24 h after operation, levels of β-EP at 4 h and 24 h, and the first time for postoperative analgesia were better improved in the magnesium sulfate group. Conclusion Epidural administration of magnesium sulfate combined with morphine is an effective and safe method to improve the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery.