Effects Of Magnesium Sulfate On Postoperative Quality Of Recovery In Patients Undergoing Thoracoscopic Lobectomy

Objective:To observe the effect of intraoperative magnesium sulfate on perioperative insulin resistance and postoperative quality of recovery in patients undergoing thoracoscopic lobectomy.Methods:Patients undergoing elective thoracoscopic lobectomy were randomly divided into a blank control group（group C）and a magnesium sulfate group（group M）by random table method.In group M,magnesium sulfate 10mg/kg was slowly injected intravenously 10min before induction,and magnesium sulfate 15mg/kg/h was continuously pumped intravenously after induction until specimen resection.Group C was given the same amount of normal saline.1.General information about the two groups of patients before surgery was recorded,including BMI,gender,ASA grading,one-lung ventilation time,anesthesia time,operation time,fluid intake and output,etc.2.The intraoperative conditions of the patients in the two groups were recorded:the consumption of remifentanil,propofol,and rocuronium in the patients of group C and group M were recorded;MAP,blood glucose,HR and Sp O₂ were recorded before intubation（T0）,after intubation（T1）,10min after thoracotomy（T2）,30min after lung resection（T3）and 5min after extubation（T4）.3.Postoperative conditions of patients in the two groups were recorded:Qo R-15 was used to evaluate the patients on the day before surgery（D0）,the first day after surgery（D1）,and the second day after surgery（D2）.The fasting insulin resistance index and C-reactive protein of the two groups were recorded at D0,D1,and D2.The extubation time was recorded.VAS pain score at 5min,D1,and D2 after extubation;length of stay and incidence of pulmonary complications 7 days after surgery.Results:1.There was no significant difference in general conditions between the two groups before the surgery（P>0.05）.2.intraoperative conditions:compared with group C,the consumption of remifentanil,propofol and rocuronium in group M was significantly lower（P<0.05）;Compared with group C,MAP and HR in group M were significantly decreased at T2,T3,and T4,and HR was significantly decreased at T2 and T4（P<0.05）.There was no significant difference in blood oxygen saturation and blood glucose between the two groups at T0～T4.3.Comparison of postoperative conditions:Qo R-15 Comparison:Compared with D0,Qo R-15 scores of D1 and D2 were decreased（P<0.05）;The mean total score of Qo R-15 scale in group M was significantly higher than that in group C at D1 and D2（105.37±3.60vs111.37±3.81;109.47±4.34vs 114.23±4.22）（P<0.05）.The insulin resistance index in group M was significantly lower than that in group C at D1 and D2（P<0.05）;There was no significant difference in CRP（P>0.05）.The VAS scores of D1 and D2 in group M were lower than those in group C（Z=2.09,P=0.04;Z=0.21,P=0.04）;There was no significant difference in VAS scores of T4 between the two groups（Z=0.31,P=0.75）.Compared with group C,there was no significant difference in extubation time,incidence of postoperative pulmonary complications,and length of hospital stay in group M.In terms of analgesic pump use,there was no significant difference in the first time of analgesic pump press between the two groups（P>0.05）.Conclusion:Intraoperative intravenous infusion of magnesium sulfate（10mg/kg induction,15mg/kg/h continuous pump infusion after induction until specimen resection）can reduce the degree of is let number resistance,improve the score of postoperative Qo R-15 scale,and improve the quality of postoperative recovery.