بررسی تأثیر انفوزیون سولفات منیزیوم در اتاق عمل در ایجاد بی دردی پس از عمل جراحی کیسه صفرا به روش لاپاراسکوپیک

Subject Areas : علوم پزشکی

Mojgan Raisi ¹ , Vahid Naghferati ² , Fatemeh Broomand Jahed aval ³

1 - استادیار،دانشکده پزشکی،دانشگاه آزاد اسلامی مشهد، مشهد، ایران
2 - استادیار،دانشکده پزشکی،دانشگاه آزاد اسلامی مشهد، مشهد، ایران
3 - دانشجوی رشته پزشکی، دانشکده پزشکی، دانشگاه آزاد اسلامی مشهد، مشهد، ایران

Received: 2017-06-05 Accepted : 2017-06-05 Published : 2017-05-22

Keywords: Magnesium Sulphate – postoperative analgesia – cholecystectomy – laparascopy,

Abstract :

Introduction: Postoperative pain is a complex physiologic reaction to tissue injury. Postoperative analgesia by medical and nonmedical methods improves the clinical outcomes, prevents complications, economizes health services and improves patients life quality. Purpose of this study is to evaluate the effect of Magnesium Sulphate infusion in operative room on pain relief after laparascopic cholecystectomy. Methods and Material: In this clinical trial, 40 patients of laparascopic cholecystectomy with ASA I and II and age range of 30-60 years, without any operation on bile cyst presented in the hospital. After obtaining consent, the patients devided in two groups. Magnesium (M) group received 50 mg/kg Magnesium Sulphate intravenously in 100 cc Normal Saline 0.9% and the control (C) group received 100 cc Normal Saline 0.9% after intubation. Evaluation of arterial blood pressure, heart rate and pulse oxymetry before infusion of Magnesium Sulphate or Normal Saline, 15 minutes after infusion begin and at the operation end, performed. Pain measured in rest and coughing in 6 and 12 hours after anesthesia end by VAS (Visual Analogue Scale) and dose of opium drug used in recovery, 0-6 and 7-12 hours after anesthesia end, measured then recorded in questionnaire. After gathering information, opium drug dose used and VAS index, in two groups compared in hours listed above and statistically analyzed. Results: In our study there was not significant difference between two groups in age and sex (P>0.05). Pain in rest and coughing in 6 and 12 hours after anesthesia end did not have significant difference between two groups (P>0.05) and sex and age did not have statistically effect on it. The two groups which we studied did not have important difference in dose of opium used in recovery, 0-6 and 7-12 hours after anesthesia end (P>0.05). Also systolic and diastolic blood pressure and arterial oxygen saturation between two groups did not have significant difference before infusion, 15 minutes after infusion begin and at the end of infusion (P>0.05). But the heart rate average at the end of infusion, in Magnesium Sulphate group (84.1 ± 9.6) was more than Normal Saline (77.2 ± 7.6) group (P= 0.004). Conclusion: In general, in the present study it is said that prescription of 50 mg/kg Magnesium Sulphate in operation room does not have effect on pain and dose of opium drug used after laparascopic cholecystectomy and also does not lead to change in systolic and diastolic blood pressure and arterial oxygen saturation compared with control group, during and at the end of this operation. But only causes significant increase in heart rate compared with control group, at the end of operation.    

References:

                   

1. Miller R D, Pardo M C. Basics Of Anesthesia. 6^th ed. Philadelphia: Elsevier company; 2011: p.650-57,659,698-99,703-705.


2. Mentes O, Harlak A, Yigit T, Balkan A, Balkan M, Cosar A, et al. Effect of intraoperative magnesium sulphate infusion on pain relief after laparascopic cholecystectomy. Acta Anaesthesiol Scand 2008 Aug; 52:1353-59.


3. Robert W, Hurley, L wu C. Acute Postoperative Pain. In: Miller R D. Miller’s Anesthesia. 7^th ed. Philadelphia: Elsevier company; 2010. Vol. 2 p. 2757-64,2771-73.

1. Bondok R S, Abd El-Hady A M. Intra- articular magnesium is effective for postoperative analgesia in arthoscopic knee surgery. Br J Anaesth 2006 Jul; 97(3):389-92


2. Maharjan S, Shrestha S. Intraperitoneal magnesium sulphate plus bupivacaine for pain relief after laparascopic cholecystectomy. Journal of Kathmandu Medical College 2012 Jul – Sep; 1(1):21-25.


3. نقیبی خسرو، نوروزی مهرداد، طباطبایی عباس، صالحی محمد علی، ظاهرنیا زهره. اثرات تسکینی سولفات منیزیوم بر درد بعد از عمل کوله سیستکتومی: مطالعه کارآزمایی بالینی دو سو کور. مجله پژوهش در علوم پزشکی، 1381؛ 7(1):66-64.


4. صادقی مصطفی، مهرآیین افلاطون، آزاد محمد علی. بررسی تأثیر سولفات منیزیم در بی دردی پس از عمل جراحی ترمیم فتق اینگوینال. مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، 1386؛ 65(4):58-55.


5. Kaur S, Baghia N. Evaluation of Intravenous Magnesium Sulphate For Postoperative Analgesia In Upper Limb Orthopaedic Surgery Under General Anaesthesia : A Comparative Study. The Internet Journal of Anesthesiology .2012; 30(2).


6. ایمانی فرساد، نجفی اتابک، صدرالسادات حسین، خواجوی محمد رضا، شریعت محرری رضا. بررسی اثرات تسکینی سولفات منیزیم بر درد بعد از عمل در جراحی دیسک کمری. مجله انجمن آنستزیولوژی و مراقبت های ویژه، 1385؛ 28(53):41-36.

10.صادقی مصطفی، مهرآیین افلاطون، آزاد محمد علی. بررسی تأثیر سولفات منیزیم در بی دردی پس از عمل جراحی ترمیم فتق اینگوینال. مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، 1386؛ 65(4):58-55.

11.داودی مریم، طهماسبی رضا، ذوالحواریه محمد. بررسی تأثیر سولفات منیزیم وریدی بر میزان درد پس از عمل جراحی سزارین تحت بی حسی نخاعی. مجله علمی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی همدان، 1391؛ 19(4):26-20.