Aksiller brakiyal pleksus blokajında magnezyum infüzyonunun postoperatif analjeziye etkileri

Genel anesteziden sonra başlanan magnezyum sülfat infüzyonu analjezik gereksinimini azaltmaktadır. Bu çalışmada, brakiyal pleksus blokajından sonra postoperatif ilk 24 saat uygulanan magnezyum sülfat infüzyonunun blok süresi, sedasyon ve postoperatif analjezik tüketimine etkilerinin araştırılması amaçlandı. Yerel Etik Kurul onayı alınarak ASA I ve II sınıfı 70 hasta çift kör, randomize çalışmaya alındı. Brakiyal pleksus blokajı aksiller yaklaşımla lidokainin 40 ml %1.25 1/200000 adrenalinli solüsyonu kullanılarak gerçekleştirildi. Hastalara 24 saat sürede eşit volümde 5 mg.kg–1 bolus ve 500 mg.saat–1 magnezyum sülfat veya serum uygulandı. İlk 24 saatlik sürede grupların ilk ağrı duyumu, motor bloğun kalkma süresi ve analjezik gereksinimi yanında 4 saatte bir alınan sedasyon ve vizüel analog skorları değerlendirildi. İlk ağrı duyumu ve ilk analjezik kullanımı belirgin oranda artmakla birlikte magnezyum infüzyon grubunda toplam analjezik tüketiminde belirgin düzeyde azalma saptandı (Dolantin: K: 36.3 ± 42.6 mg, Mg: 11.7 ± 12.2 mg, p: 0.001). Aynı zamanda vizüel analog skorların tüm peryotlarda azaldığı gözlendi. Motor blok gerileme ve sedasyon skorları arasında fark bulunamadı. Magnezyum sülfat infüzyonunun, brakiyal pleksus blokajı uygulanan hastalar için analjezik tüketimini ve olası yan etkilerini günlük aktiviteleri etkilemeksizin azaltmada güvenli bir ilaç olduğu kanısına varıldı.

The postoperative analgesic effects of magnesium infusion on brachial plexus block

Magnesium sulphate infusion decreases analgesic requirements after general anaesthesia. Aim of this study was to assess the effects of postoperative magnesium infusion for 24 hours on duration of the block, sedation and postoperative analgesic consumption after brachial plexus block. After obtaining approval from local ethic committee, 70 ASA class I and II patients were included to the randomised double blind study. Brachial plexus block was performed using axillary approach with lignocaine 1.25 % adrenaline 1/200 000 40 ml. Groups received 5 mg.kg –1 bolus and 500 mg.h–1 magnesium sulphate infusion or saline controls at the same volume during 24 hour. Analgesia and sedation were assessed while determining time to first pain and rescue analgesic, time to regain motor capability, visual analogue scale and sedation scores for every 4 hour during postoperative 24 h. period. While time to first pain and rescue analgesic was increased, total analgesic consumption was reduced significantly on magnesium infusion group (Meperidine: C: 36.3 ± 42.6 mg, Mg: 11.7 ± 12.2 mg, p: 0.001). Visual analogue scales were also observed to be lower in all periods. Time to motor block resolution, and sedation scores were similar. Magnesium sulphate infusion is thought as a safe and suitable adjunct for reducing analgesic consumption and possible complications without interfering daily activity in patients undergoing brachial plexus block.

Kaynakça

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