| Research background and purpose:Catheter-related bladder discomfort(CRBD)after laparoscopic radical resection of gastrointestinal malignancies is a common complication,and there is a lack of studies on magnesium sulfate in the prevention of CRBD in patients after laparoscopic radical resection of gastrointestinal malignancies.Therefore,the purpose of this study was to observe the effect of magnesium sulfate on the incidence and severity of CRBD after laparoscopic radical resection of gastrointestinal malignancies.Materials and Methods:This is a prospective,randomized,controlled study,104 patients underwent laparoscopic radical resection of gastrointestinal malignancies in Deyang People’s Hospital from March 2022 to September 2022.They were all male,aged 18 to 75 years,American Society of Anesthesiologists(ASA)Physical Status I to Ⅲ.They were randomly divided into the magnesium sulfate group and control group using computergenerated random number tables.Magnesium sulfate group: a 40 mg/ kg loading dose of intravenous magnesium sulfate was administered for 10 minutes just after the induction of anesthesia,followed by an intravenous infusion of 15 mg/kg/h of intravenous magnesium sulfate during the intraoperative period.Patients in the control group received normal saline in the same manner as those in the magnesium sulfate group.The methods of anesthesia induction and maintenance were the same in both groups.After the operation,the two groups were connected with a Patient-Controlled Intravenous Analgesia pump with the same formula;If moderate to severe catheterrelated bladder discomfort or NRS score ≥ 4 after surgery,press the PCIA pump and reassess after 10 minutes.2 mg tramadol was administered if the patient still feels no comfortable.Duration of surgery,postoperative extubation time,total infusion,bleeding volume,and urine output of the patient during surgery were recorded.The average arterial pressure(MAP)and heart rate(HR)before anesthesia induction(T1),after intravenous drip(T2),at the beginning of surgery(T3),at the end of surgery(T4),1hour after surgery(T5),2 hours after surgery(T6)and 6 hours after surgery(T7)were recorded either.And the incidence and severity of CRBD were recorded 0 hours after surgery(when entering the PACU),1 hour after surgery,2 hours after surgery,and 6hours after surgery.The NRS score of patients at 0,1,2,6,12,24,and 48 hours after surgery,patient-controlled analgesia pump use(number of compressions and analgesic medication)at 24 hours postoperatively,the use of remedial medications,intraoperative and postoperative adverse effects were still important.Results:1.In this study,165 patients were screened.Excluding 61 cases(46 cases did not meet the inclusion criteria,9 cases refused to participate and 6 patients canceled surgery),104 patients were included in the study.And 16 patients were excluded,because of the failure to successfully place the urinary catheter,or the change of surgical method and postoperative admission to the ICU.Therefore 88 patients were included in the analysis([45 patients in the magnesium sulfate group(M group),and 43 patients in the control group(C group).There were no significant differences in age,height,weight,body mass index,type of surgery,model of urinary catheter placement,operation time,extubation time,intraoperative drug use(sufentanil,rocuronium bromide,and propofol),fluid rehydration,urine output,and blood loss between the two groups(P>0.05).The difference in intraoperative remifentanil use was statistically significant(P>0.05).2.The incidence of catheter-related bladder discomfort in patients 0,1,2,and 6hours after surgery in group M was lower than that in group C(P<0.05).And the severity of catheter-related bladder discomfort in patients 0 and 1 hour after surgery in group M was lower than that in group C(P<0.05).There were no significant differences in the severity of catheter-related bladder discomfort between the two groups 2 and 6hours after surgery(P>0.05).3.In the postoperative 0,1,2,and 6 hours,the NRS scores of group M were lower than those in group C(P<0.05).There were no significant differences in NRS scores between the two groups 12,24,and 48 hours after surgery(P>0.05).The difference in the number of patient-controlled analgesia pump and sufentanil requirements between the two groups at 24 hours after surgery was statistically significant(P<0.05).4.The MAP and HR of group C were higher than those of group M at the beginning of surgery,and the difference was statistically significant(P<0.05).The MAP and HR of the two groups were consistent before anesthesia induction,after intravenous infusion of test drug load,at the end of the surgery,1 hour after surgery,2 hours after surgery,and 6 hours after surgery,and the difference was not statistically significant(P>0.05).5.There was no statistically significant difference in the use,intraoperative,and postoperative adverse reactions of postoperative remedial drugs between the two groups(P>0.05).Conclusions:1.Magnesium sulfate reduced the incidence and severity of early CRBD after laparoscopic radical resection of gastrointestinal malignancies.2.Magnesium sulfate reduced the NRS score and the demand for early postoperative analgesia drugs after laparoscopic radical resection of gastrointestinal malignancies.3.Magnesium sulfate stabilized the changes in MAP and HR caused by surgical stimulation of radical gastrointestinal malignancies in the laparoscopic gastrointestinal tract.4.The use of low therapeutic doses of magnesium sulfate during surgery does not increase the occurrence of intraoperative and postoperative adverse reactions. |
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