镁与口腔内窥镜食道肌切开术后的食道疼痛:一项随机、双盲、安慰剂对照试验。

IF 4.6 2区 医学 Q1 ANESTHESIOLOGY
Anesthesia and analgesia Pub Date : 2025-01-01 Epub Date: 2024-06-07 DOI:10.1213/ANE.0000000000006990
Richard K Kim, James W Kim, Timothy Angelotti, Micaela Esquivel, Ban C Tsui, Joo H Hwang
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引用次数: 0

摘要

背景:67%的患者在口腔内窥镜食管肌切开术(POEM)后会出现术后食管疼痛。镁可作为平滑肌松弛剂。本研究探讨了术中使用镁是否能减轻 POEM 患者的术后食道疼痛:在这项双盲安慰剂对照试验中,92 名患者随机接受硫酸镁(50 毫克/千克-1(总重量))栓剂,然后以 25 毫克/千克-1.小时-1 的剂量输注,或 0.9% 生理盐水。所有患者的术中镇痛都是标准化的。主要结果是麻醉后护理病房(PACU)中经过验证的改良食管症状问卷(ESQ)的评分。疼痛评分、阿片类药物需求量和调查问卷评分收集至术后第 1 天:镁组在 PACU(中位数[第 25-75 位],24 [18-31] vs 35 [28-42];中位数差异[95% 置信区间,CI],10 [6-13];P < .0001)和术后第 1 天(16 [14-23] vs 30 [24-35];P < .0001)的 ESQ 评分明显较低。在 PACU(平均值 ± 标准差 [SD] [99% CI],4.7 ± 10 [1-9] mg vs 29 ± 21 [21-37] mg;P < .0001)和术后第 1 天(1 ± 3.7 [0-2.5] mg vs 13 ± 23 [4-23] mg;P = .0009),镁组所需阿片类药物较少。镁剂组在PACU(0 [0-3] vs 5 [5-7];P < .0001)和术后第1天(0 [0-2] vs 4 [3-5];P < .0001)的疼痛评分较低:结论:随机接受术中镁治疗的 POEM 患者在术后 24 小时内食管不适的严重程度和阿片类药物的需求量持续下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Magnesium and Esophageal Pain After Peroral Endoscopic Myotomy of the Esophagus: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Postoperative esophageal pain occurs in 67% of patients after peroral endoscopic esophageal myotomy (POEM). Magnesium can act as a smooth muscle relaxant. This study investigated whether intraoperative magnesium can reduce postoperative esophageal pain in patients undergoing POEM.

Methods: In this double-blind, placebo-controlled trial, 92 patients were randomized to receive either magnesium sulfate as a 50 mg.kg -1 (total body weight) bolus followed by an infusion at 25 mg.kg -1 .hr -1 , or 0.9% saline. Intraoperative analgesia was standardized in all patients. The primary outcome was the score from a validated, modified Esophageal Symptoms Questionnaire (ESQ) in the postanesthesia care unit (PACU). Pain scores, opioid requirements, and questionnaire scores were collected through postoperative day 1.

Results: ESQ scores were significantly lower in the magnesium group in the PACU (median [25th-75th], 24 [18-31] vs 35 [28-42]; median difference [95% confidence interval, CI], 10 [6-13]; P < .0001) and on postoperative day 1 (16 [14-23] vs 30 [24-35]; P < .0001). Less opioids were needed in the magnesium group in the PACU (mean ± standard deviation [SD] [99% CI], 4.7 ± 10 [1-9] mg vs 29 ± 21 [21-37] mg; P < .0001) and on postoperative day 1 (1 ± 3.7 [0-2.5] mg vs 13 ± 23 [4-23] mg; P = .0009). Pain scores were lower in the magnesium group in the PACU (0 [0-3] vs 5 [5-7]; P < .0001) and on postoperative day 1 (0 [0-2] vs 4 [3-5]; P < .0001).

Conclusions: Patients undergoing POEM randomized to receive intraoperative magnesium had sustained reductions in esophageal discomfort severity and opioid requirements 24 hours after surgery.

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来源期刊
Anesthesia and analgesia
Anesthesia and analgesia 医学-麻醉学
CiteScore
9.90
自引率
7.00%
发文量
817
审稿时长
2 months
期刊介绍: Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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