دورية أكاديمية
أعرض في EDS

Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study.

التفاصيل البيبلوغرافية
العنوان: Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study.
المؤلفون: Silva Filho SE; Department of Anesthesiology, Hospital da Sociedade Portuguesa de Beneficência de Santos, Santos, SP, Brazil., Dainez S; Department of Anesthesiology, Hospital da Sociedade Portuguesa de Beneficência de Santos, Santos, SP, Brazil., Gonzalez MAMC; Department of Anesthesiology, Hospital da Sociedade Portuguesa de Beneficência de Santos, Santos, SP, Brazil., Angelis F; Department of Anesthesiology, Hospital da Sociedade Portuguesa de Beneficência de Santos, Santos, SP, Brazil., Vieira JE; Department of Anesthesiology, Universidade de Sao Paulo, Santos, SP, Brazil., Sandes CS; Hospital Santos Dumont, Sao Jose Dos Campos, SP, Brazil.
المصدر: Anesthesiology research and practice [Anesthesiol Res Pract] 2022 Oct 26; Vol. 2022, pp. 2642488. Date of Electronic Publication: 2022 Oct 26 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Hindawi Pub. Corp Country of Publication: United States NLM ID: 101532982 Publication Model: eCollection Cited Medium: Print ISSN: 1687-6962 (Print) Linking ISSN: 16876962 NLM ISO Abbreviation: Anesthesiol Res Pract Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: New York, N.Y. : Hindawi Pub. Corp., 2008-
مستخلص: Background: Magnesium sulfate reduces pain scores and analgesic consumption. Its use as an analgesic resource in opioid-free or opioid-sparing techniques have also been tested. The evaluation of the antinociceptive potency of drugs and doses indirectly, through hemodynamic oscillations has been questioned. A relatively new algorithm called the plethysmographic stress index has been considered sensitive and relatively specific as a parameter for assessing the need for intraoperative analgesia.
Objectives: The aim of this trial was to assess the intraoperative analgesic capacity of magnesium sulfate compared to remifentanil. The secondary objectives were propofol consumption and its latency, the consumption of opioids, ephedrine, and cisatracurium. Patients and Methods . Forty patients scheduled for post-bariatric dermolipectomy were randomly assigned to two groups to receive total intravenous anesthesia with target-controlled hypnosis induced with propofol. Analgesia was obtained in the remifentanil group with remifentanil at an initial dose of 0.2  μ g·kg -1 ·min -1 and in the magnesium sulfate group with magnesium sulfate 40 mg·kg -1  + 10 mg·kg -1 ·h -1 .
Results: There was no statistical hemodynamic difference between the groups before and after orotracheal intubation ( p  = 0.062) and before and after the surgical incision ( p  = 0.656). There was also no statistical difference in the variation of mean arterial pressure before and after intubation ( p  = 0.656) and before and after the surgical incision ( p  = 0.911). There was similar consumption of cisatracurium, ephedrine, and postoperative opioids between the groups. Some patients in the magnesium sulfate group needed more intraoperative fentanyl and propofol, although the latency of propofol was similar in both the groups.
Conclusion: We conclude that using magnesium sulfate in intravenous general anesthesia for post-bariatric dermolipectomy is related to a significant reduction in opioid consumption without compromising hemodynamic stability. Overall, PSI monitoring was helpful in driving the analgesic strategy. The use of magnesium sulfate proved to be an important adjunct in the scenario presented, allowing the use of opioids to be avoided in certain cases. We found no statistical differences in the consumption of neuromuscular blocker and vasoconstrictor. Substituting opioids for magnesium sulfate leads to an increase in propofol consumption in the scenario presented. Studies with a larger sample are needed to corroborate the results presented and evaluate other potential advantages in reducing opioid consumption.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 S. E. Silva Filho et al.)
References: Anesthesiology. 2000 Aug;93(2):409-17. (PMID: 10910490)
Drugs. 2003;63(7):649-71. (PMID: 12656645)
J Int Med Res. 2018 Nov;46(11):4386-4398. (PMID: 30198405)
Acta Anaesthesiol Scand. 2015 Nov;59(10):1212-31. (PMID: 26346577)
Pain Physician. 2011 Mar-Apr;14(2):145-61. (PMID: 21412369)
Lancet. 2019 Apr 13;393(10180):1558-1568. (PMID: 30983591)
Acta Anaesthesiol Scand. 2008 Sep;52(8):1038-45. (PMID: 18840101)
Br J Anaesth. 1961 Jan;33:3-8. (PMID: 13772304)
J Pak Med Assoc. 2011 Dec;61(12):1220-5. (PMID: 22355971)
Anesth Analg. 1992 Jan;74(1):129-36. (PMID: 1734773)
Intensive Care Med. 2013 Jan;39(1):117-22. (PMID: 23129148)
Br J Clin Pharmacol. 2016 Mar;81(3):420-7. (PMID: 26183037)
Sci Pract Perspect. 2002 Jul;1(1):13-20. (PMID: 18567959)
J Cardiothorac Vasc Anesth. 2012 Jun;26(3):526-31. (PMID: 22361482)
J Clin Anesth. 2016 Nov;34:524-34. (PMID: 27687446)
Am Heart J. 1984 Jul;108(1):188-93. (PMID: 6375330)
Korean J Anesthesiol. 2013 Jul;65(1):4-8. (PMID: 23904932)
Anesth Analg. 2000 Jul;91(1):110-6. (PMID: 10866896)
Anesthesiology. 2008 Aug;109(2):308-17. (PMID: 18648240)
Anesthesiology. 2010 May;112(5):1175-83. (PMID: 20418698)
Anesth Analg. 2004 May;98(5):1385-400, table of contents. (PMID: 15105220)
Br J Anaesth. 2014 Jun;112(6):991-1004. (PMID: 24829420)
Cochrane Database Syst Rev. 2014 May 28;(5):CD010909. (PMID: 24865567)
BMC Anesthesiol. 2017 Feb 21;17(1):30. (PMID: 28222697)
Anesthesiol Clin. 2017 Mar;35(1):95-106. (PMID: 28131123)
Pain Physician. 2008 Mar;11(2 Suppl):S105-20. (PMID: 18443635)
Cureus. 2021 Dec 13;13(12):e20377. (PMID: 35036210)
World J Gastroenterol. 2012 Mar 28;18(12):1391-6. (PMID: 22493554)
Middle East J Dig Dis. 2013 Jan;5(1):5-16. (PMID: 24829664)
Br J Anaesth. 1999 Aug;83(2):302-20. (PMID: 10618948)
J Pers Med. 2021 Dec 02;11(12):. (PMID: 34945745)
J Matern Fetal Neonatal Med. 2021 Mar;34(6):966-978. (PMID: 31092073)
Br J Anaesth. 2009 Oct;103(4):586-93. (PMID: 19648155)
Braz J Anesthesiol. 2021 Sep-Oct;71(5):550-557. (PMID: 34537125)
Can J Anaesth. 2003 Feb;50(2):172-8. (PMID: 12560310)
Br J Anaesth. 2010 Oct;105(4):533-7. (PMID: 20682572)
تواريخ الأحداث: Date Created: 20221107 Latest Revision: 20221108
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9629917
DOI: 10.1155/2022/2642488
PMID: 36339775
قاعدة البيانات: MEDLINE
الوصف
تدمد:1687-6962
DOI:10.1155/2022/2642488