口服镁剂对剖宫产术后蛛网膜下腔麻醉所致头痛的预防疗效评价:

一项随机临床试验

贵州医科大学麻醉与心脏电生理课题组

翻译：安丽编辑：潘志军审校：曹莹

背景

硬膜穿刺后头痛(PDPH)是蛛网膜下腔麻醉常见的并发症。它常会在几天后消失，但在一些患者可能会更严重，并持续数周。

目的

本研究首次探讨口服镁剂对剖宫产术后PDPH发生的预防作用。

方法

在这项双盲随机临床试验中，将择期剖宫产行蛛网膜下腔麻醉的100例患者随机分为2组，干预组：口服镁剂300 mg，对照组：口服淀粉300 mg。分别于剖宫产术后1、2、3 d测量两组患者头痛发生率、严重程度及镇痛药的用量。数据使用SPSS 22版本在95%置信区间进行分析。

结果

干预组和对照组在术后1、2、3天发生PDPH的发生率分别为第1天8% vs 24% (P = 0.029)、第2天10% vs 26% (P = 0.039)、第3天12% vs 18% (P = 0.401)。干预组和对照组疼痛严重程度的均值和标准差分别为:第1天0.52±1.83 vs 1.5±2.84 (P = 0.03)，第2天0.70±2.19 vs 1.58±2.86 (P = 0.05)，第3天0.82±2.32 vs 1.18±2.62 (P = 0.43)。虽然对照组更多的患者接受了补救性镇痛，但两组间无显著差异。

结论

在剖宫产的女性患者中，术前2小时口服300 mg镁剂可显著降低PDPH的发生率和严重程度，但其对减少止痛药消耗的影响并不显著。

原始文献来源

Mahshid Nikooseresht , Pouran Hajian , Abas Moradi and Maryam Sanatkar.Evaluation of the Effffects of Oral Magnesium Sachet on the Prevention of Spinal Anesthesia-Induced Headache After Cesarean Section: A Randomized Clinical Trial.Anesth Pain Med. 2022 February; 12(1):e121834.doi: 10.5812/aapm.121834.

英文原文

Evaluation of the Effffects of Oral Magnesium Sachet on the Prevention of Spinal Anesthesia-Induced Headache After Cesarean Section: A Randomized Clinical Trial

Abstract

Background: Post-dural puncture headache (PDPH) is a common complication of spinal anesthesia. It often goes away after a few days but may be more severe in some patients and persists for weeks.

Objectives: This study aimed to evaluate the effect of oral magnesium on the prevention of PDPH after cesarean section for the first time.

Methods: In this double-blind, randomized clinical trial, 100 candidates for elective cesarean section under spinal anesthesia were randomly divided into 2 groups: (i) the intervention group that received 300 mg of oral magnesium powder and (ii) the control group that received starch powder. The frequency and severity of headache and amount of analgesic consumption in both groups

were measured 1, 2, and 3 days after cesarean section. Data were analyzed using SPSS version 22 at 95% CI.

Results: The frequency of PDPH 1, 2, and 3 days after surgery was 8% vs 24% (P = 0.029), 10% vs 26% (P = 0.039), and 12% vs 18% (P =0.401) in the intervention and control groups, respectively. The mean and SD of pain severity was 0.52 ± 1.83 vs 1.5 ± 2.84 (P = 0.03)on the first day, 0.70 ± 2.19 vs 1.58 ± 2.86 (P = 0.05) on the second day, and 0.82 ± 2.32 vs 1.18 ± 2.62 on the third day (P = 0.43) in the intervention and control groups, respectively. Although more patients in the control group received rescue analgesia, no significant difference was seen between the 2 study groups.

Conclusions: In women candidates for cesarean section, oral administration of 300 mg magnesium 2 hours before surgery significantly reduces the frequency and severity of PDPH, but its impact on reducing analgesic consumption is not significant.

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