OBJECTIVE To investigate the effect of systemic intraoperative administration of magnesium sulphate when used in the context of a multimodal pain management plan on analgesics consumption and pain scores, and perioperative outcomes after lumbar laminectomy surgery. METHODS Seventy-four patients undergoing lumbar laminectomy were enrolled in this randomized, double-blind, placebo-controlled trial. Participants were randomly allocated to receive magnesium (20 mg/kg iv given as bolus before anesthesia induction followed by 20 mg/kg/h civ until surgery completion) or saline. Hemodynamic variables and desflurane consumption were noted at predefined time-intervals intraoperatively. Primary outcome was postoperative cumulative analgesic consumption over 24 h, while pain intensity (assessed by Visual Analogue Scale [VAS] at 1, 2, 4, 6 and 24 h), intraoperative hemodynamics and opioid requirements, recovery profile, time to first analgesic request, and adverse effects constituted secondary end-points. RESULTS Demographics, surgery duration, desflurane requirements, and recovery profile were comparable between groups. Magnesium attenuated hemodynamic response during incision and emergence from anesthesia. Postoperative analgesics consumption in morphine iv equivalents (mean difference -9.24 [95 %CI -13.31, -5.17] mg; p = 0.001) and VAS scores at all-time points of assessment were lower in magnesium group; this effect peaked at 4 h (mean difference -2.15 [95 %CI -3.21,-1.09; p = 0.001]. Magnesium reduced intraoperative remifentanil consumption and prolonged the time-interval to first rescue analgesia (p < 0.01). No notable adverse effects were recorded. CONCLUSION It occurs that magnesium infusion during lumbar laminectomy surgery potentiates perioperative analgesia and reduces analgesic requirements up to 24 h postoperatively. No profound adverse effect on either intraoperative hemodynamics or any other clinically relevant endpoints becomes evident.

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硫酸镁作为腰椎椎板切除术围手术期疼痛控制的辅助多模式镇痛方法的实施：一项随机安慰剂对照临床试验

目的 研究在多模式疼痛管理计划的背景下全身术中给予硫酸镁对镇痛药用量和疼痛评分以及腰椎椎板切除术后围手术期结果的影响。方法 74 名接受腰椎椎板切除术的患者参加了这项随机、双盲、安慰剂对照试验。参与者被随机分配接受镁（20 mg/kg iv 在麻醉诱导前作为推注给药，然后 20 mg/kg/h civ 直到手术完成）或生理盐水。在术中预先确定的时间间隔内记录血流动力学变量和地氟醚消耗量。主要结果是术后 24 小时内累积镇痛剂消耗量，而疼痛强度（在 1、2、4、6 和 24 小时通过视觉模拟量表 [VAS] 评估），术中血流动力学和阿片类药物需求、恢复情况、首次要求镇痛的时间和不良反应构成次要终点。结果 组间人口统计学、手术持续时间、地氟醚需求和恢复情况具有可比性。镁在切口和麻醉苏醒期间减弱血流动力学反应。镁组的术后镇痛剂使用吗啡当量（平均差 -9.24 [95 %CI -13.31, -5.17] mg；p = 0.001）和所有时间评估点的 VAS 评分较低；这种效果在 4 小时达到峰值（平均差异 -2.15 [95 %CI -3.21,-1.09; p = 0.001]。镁减少术中瑞芬太尼的消耗量并延长到第一次救援镇痛的时间间隔（p < 0.01）。无明显不良反应效果被记录下来。结论 腰椎椎板切除术期间输注镁可增强围手术期镇痛并减少术后 24 小时的镇痛需求。对术中血流动力学或任何其他临床相关终点都没有明显的不良影响。