تأثیر انفوزیون وریدی سولفات منیزیم بر میزان مصرف اوپیوئید و وضعیت همودینامیک پس از جراحی هیسترکتومی: کارآزمایی بالینی دوسوکور

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد آموزش پرستاری داخلی- جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 دانشیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: با توجه به عوارض نامطلوب اوپیوئیدهای تزریقی پس از جراحی­هایی همچون هیسترکتومی و همچنین نتایج ضدو‌نقیض مناسب­ترین روش استفاده از سولفات منیزیم جهت به صفر رساندن مصرف اوپیوئید پس از جراحی، مطالعه حاضر با هدف بررسی تأثیر انفوزیون وریدی سولفات منیزیم بر میزان مصرف اوپیوئید و وضعیت همودینامیک پس از جراحی هیسترکتومی انجام شد.
روش­کار: این مطالعه کارآزمایی بالینی دوسوکور در سال 1390 بر روی 60 بیمار کاندید جراحی هیسترکتومی در بیمارستان امام رضا (ع) تبریز انجام شد. افراد به­‌صورت تصادفی به دو گروه مداخله و کنترل تقسیم شدند. برای گروه مداخله، نیم ساعت قبل از بیهوشی، سولفات منیزیم به میزان 50 میلی‌گرم بر کیلوگرم به صورت بولوس به بیماران تزریق شد. پس از پایان عمل جراحی و ترخیص بیماران از واحد ریکاوری، انفوزیون 500 میلی‌گرم در ساعت منیزیم سولفات تا 24 ساعت پس از جراحی ادامه یافت. وضعیت همودینامیک بیماران و میزان مصرف اوپیوئید در چک‌لیست محقق ساخته ثبت شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 19) و آزمون­های من‌ویتنی‌یو و تی تست انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در وضعیت همودینامیک بیماران دو گروه در تمامی زمان­ها اختلاف آماری معنی­داری مشاهده شد؛ به‌طوری‌که گروه مداخله دارای وضعیت پایدارتری شده بود (حداکثر میزان p برابر 04/0)، همچنین میزان مصرف مخدر در گروه مداخله با گذشت زمان با کاهش همراه بود؛ حال آنکه کاهش قابل توجهی در گروه کنترل مشاهده نشد.
نتیجه­گیری: استفاده از سولفات منیزیم موجب ثبات وضعیت همودینامیک می­گردد و بر کاهش نیاز به اوپیوئید تأثیرگذار است، اما نمی­تواند نیاز به اوپیوئید پس از جراحی هیسترکتومی را به صفر برساند.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of intravenous infusion of magnesium sulfate on opioid use and hemodynamic status after hysterectomy: double-blind clinical trial

نویسندگان [English]

  • Mehdi Khanbabaei Gol 1
  • Davood Aghamohammadi 2
1 M.Sc. in Internal-Surgery Nursing Education, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Associate Professor, Department of Anesthesia, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Due to adverse effects of injection opioids after surgeries such as hysterectomy and also, controversial results, the most appropriate method for using magnesium sulfate to minimize the postoperative opioid use, this study was performed with aim to determine the effect of intravenous infusion of magnesium sulfate on opioid use and hemodynamic status after hysterectomy.
Methods: This double-blind clinical trial was conducted on 60 patients who were candidates for hysterectomy in Tabriz Imam Reza Hospital in 2018. The subjects were randomly divided into intervention and control groups. For the intervention group, half an hour before anesthesia, 50mg/kg magnesium sulfate was injected as bolus to the patients. After the end of surgery, and patients' discharge from the recovery unit, infusion of magnesium sulfate 500mg/hr continued for up to 24 hours after surgery. The hemodynamic status of patients and opioid use were recorded in the researcher-made checklist. Data were analyzed by SPSS software (version 19) and Mann-Whitney U and t-test. P <0.05 was considered statistically significant.
Results: There was a significant difference in hemodynamic status of patients in both groups at all times, so that the intervention group had a more stable status (maximum P value was 0.04), also, the opioid use in the intervention group was associated with a decrease over time, while no significant decrease was observed in the control group.
Conclusion: The use of magnesium sulfate leads to the stability of hemodynamic status and reduces the need for opioid, but it cannot minimize the need for opioids after hysterectomy.

کلیدواژه‌ها [English]

  • Hysterectomy
  • Magnesium sulfate
  • Opioids
  • Postoperative pain
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