Effects of intra-operative magnesium sulfate infusion on orthognathic surgery: A prospective and randomized controlled trial

被引:0
|
作者
Hua, Xiaoxiao [1 ,2 ]
Chen, Yanling [1 ]
Wu, Zhi [1 ]
Zheng, Guangsen [3 ]
Yang, Dongye [3 ]
Li, Jing [1 ]
Wu, Qiaomei [1 ]
Fan, Wenguo [1 ,2 ,4 ]
机构
[1] Sun Yat Sen Univ, Hosp Stomatol, Guanghua Sch Stomatol, Dept Anesthesiol, 74 Zhongshan Rd 2, Guangzhou 510080, Peoples R China
[2] Guangdong Prov Key Lab Stomatol, Guangzhou, Peoples R China
[3] Sun Yat Sen Univ, Hosp Stomatol, Guanghua Sch Stomatol, Dept Oral & Maxillofacial Surg, Guangzhou, Peoples R China
[4] 56 Lingyuanxi Rd, Guangzhou 510080, Peoples R China
基金
中国国家自然科学基金;
关键词
Magnesium sulfate; PONV; Postoperative pain; Inflammation; Orthognathic surgery; CONTROLLED HYPOTENSION; POSTOPERATIVE NAUSEA; BLOOD-LOSS; ANESTHESIA; PAIN; REMIFENTANIL; HYPERALGESIA; ANALGESIA;
D O I
10.1016/j.heliyon.2024.e30342
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Purpose: To comprehensively understand the effects of intra-operative infusion of magnesium sulfate on patients who underwent orthognathic surgery, including remifentanil consumption, postoperative pain, postoperative nausea and vomiting (PONV), inflammatory response, and serum magnesium levels. Methods: Seventy-five adult patients undergoing orthognathic surgery under general balanced anesthesia were randomly divided into two groups. One group (Group M) received 50 mg/kg of magnesium sulfate in 20 mL 0.9 % saline after intubation, followed by a continuous infusion at a rate of 15 mg/kg/h until 30 min before the anticipated end of surgery. The other group (Group C) received an equal volume of isotonic saline as a placebo. (Clinical trial registration number: chiCTR2100045981). Results: The primary outcome was remifentanil consumption. The secondary outcomes included the pain score assessed using the verbal numerical rating scale (VNRS) and PONV assessed using a Likert scale. Remifentanil comsumption in Group M was lower than Group C (mean +/- SD: 0.146 +/- 0.04 mu g/kg/min vs. 0.173 +/- 0.04 mu g/kg/min, P = 0.003). At 2 h after surgery, patients in Group C suffered more severe PONV than those in Group M (median [interquartile range, IQR]: 1 [3] vs. 1 [0], mean rank: 31.45 vs. 42.71, P = 0.040). At post-anesthesia care unit (PACU), postoperative pain in Group C was severe than Group M (3 [1] vs. 3 [0], mean rank: 31.45 vs. 42.71, P = 0.013). Changes in haemodynamics and surgical field scores did not differ between the groups (all P > 0.05). The levels of cytokines (IL-4, IL-6, IL-8, IL-10, TNF-a, and MIP-1 beta) were not significantly different between the groups after surgery (all P > 0.05). Postoperative serum magnesium levels in Group C were lower than those in Group M (0.74 +/- 0.07 mmol/L vs. 0.91 +/- 0.08 mmol/L, P = 0.000) and the preoperative level (0.74 +/- 0.07 mmol/L vs. 0.83 +/- 0.06 mmol/L, P = 0.219). Conclusions: In orthognathic surgery, magnesium sulfate administration can reduce remifentanil requirement and relieve PONV and postoperative pain in the early postoperative phase.
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页数:10
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