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首页> 外文期刊>British journal of anaesthesia >Does the prophylactic administration of magnesium sulphate to patients undergoing thoracotomy prevent postoperative supraventricular arrhythmias? A randomized controlled trial.
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Does the prophylactic administration of magnesium sulphate to patients undergoing thoracotomy prevent postoperative supraventricular arrhythmias? A randomized controlled trial.

机译：开胸手术患者预防性使用硫酸镁是否可以预防术后室上性心律失常？一项随机对照试验。

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BACKGROUND: Supraventricular arrhythmias (SVA) are common after thoracic surgery and are associated with increased morbidity and mortality. This prospective, randomized, double-blind, placebo-controlled trial examined the effects of perioperative magnesium on the development of postoperative SVA. METHODS: Two hundred patients undergoing thoracotomy for lobectomy, bi-lobectomy, pneumonectomy, or oesophagectomy were recruited and randomly allocated into two groups. The treatment group received magnesium (5 g daily) intraoperatively, and on days 1 and 2 after operation, the control group received placebo. The primary outcome of the study was the development of SVA within the first 5 days after operation. RESULTS: There were 100 patients in each arm of the study, with one withdrawal and three lost to follow-up in the treatment group and four withdrawals in the control group. Ninety-six patients received magnesium and 96 received placebo. There was no difference in the incidence of SVA between the treatment and control groups, 16.7% (16/96) vs 25% (24/96), P=0.16. In the predefined subgroup analysis, patients at highest risk of arrhythmias (those undergoing pneumonectomy) had a significant reduction in the frequency of SVA, 11.1% (2/18) vs 52.9% (9/17), P=0.008. There were no differences in hospital length of stay or mortality. Patients receiving i.v. magnesium experienced a higher frequency of minor side-effects (stinging at injection site). The treatment was otherwise well tolerated. CONCLUSIONS: Overall, prophylactic magnesium did not reduce the incidence of SVA in patients undergoing thoracotomy. However, it reduced the incidence of SVA in the high-risk cohort of patients undergoing pneumonectomy. (ISRCTN22028180.).
机译：背景：室上性心律失常（SVA）在胸外科手术后很常见，并与发病率和死亡率增加相关。这项前瞻性，随机，双盲，安慰剂对照试验研究了围手术期镁对术后SVA发生的影响。方法：招募了200例行肺叶切除，双叶切除，肺切除或食管切除术的患者，并随机分为两组。治疗组术中接受镁（每天5 g），并且在术后第1天和第2天，对照组接受安慰剂。该研究的主要结果是在手术后的前5天内出现SVA。结果：研究的每组有100例患者，治疗组1例退出随访，3例失访，而对照组则有4例退出随访。 96名患者接受了镁治疗，9​​6名患者接受了安慰剂治疗。治疗组和对照组之间SVA的发生率无差异，分别为16.7％（16/96）和25％（24/96），P = 0.16。在预定义的亚组分析中，心律失常风险最高的患者（接受肺切除术的患者）的SVA频率显着降低，分别为11.1％（2/18）和52.9％（9/17），P = 0.008。住院时间或死亡率没有差异。接受静脉注射的患者镁的次要副作用（注射部位的刺痛）发生频率更高。否则，治疗耐受性良好。结论：总体而言，预防性镁不能降低开胸手术患者中SVA的发生率。但是，它降低了接受肺切除术的高危人群中SVA的发生率。 （ISRCTN22028180。）。

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