揭示普通腹部手术围手术期镁的镇痛效果：随机对照试验的系统回顾和荟萃分析。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology Pub Date : 2024-06-05 DOI:10.1016/j.bjane.2024.844524

Yasin Avci, Manikandan Rajarathinam, Neha Kalsekar, Qutaiba Tawfic, Sarah Krause, Derek Nguyen, Eric Liu, Mahesh Nagappa, Yamini Subramani

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引用次数: 0

摘要

背景：先前的研究已证实镁可有效缓解术后疼痛。本文旨在评估硫酸镁对在全身麻醉下接受普通腹部手术的成人围手术期镇痛效果：主要目的是评估接受硫酸镁治疗的患者与对照组患者在术后 6 小时和 24 小时的疼痛评分。次要结果是术后阿片类药物消耗量、围手术期并发症和抢救镇痛时间：通过全面的数据库搜索，确定了对接受腹部手术全身麻醉的成人进行硫酸镁与对照组比较的研究。采用随机效应模型，数据以均数±标准差（SD）或比值比（OR）及相应的 95% 置信区间（95% CI）表示。双侧 P 值小于 0.05 被认为具有统计学意义：共有 31 项研究（涉及 1762 名参与者）符合纳入标准。与对照组相比，镁组在早期（6 小时内）和晚期（24 小时内）的术后疼痛评分都明显较低。早期平均评分为 3.1 ± 1.4 vs. 4.2 ± 2.3，晚期平均评分为 2.3 ± 1.1 vs. 2.7 ± 1.5，总体平均差 (MD) 为 -0.72; 95% CI -0.99, -0.44; p < 0.00001。与生理盐水对照组相比，硫酸镁组的术后阿片类药物用量和哆嗦发生率更低，首次镇痛用药时间更长：结论：硫酸镁可减少普通腹部手术的术后疼痛和阿片类药物的用量。

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Unravelling the analgesic effects of perioperative magnesium in general abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

Background

Prior research has established the effectiveness of magnesium in relieving postoperative pain. This article aims to evaluate magnesium sulfate for perioperative analgesia in adults undergoing general abdominal surgery under general anesthesia.

Objective

The primary aim was to assess pain scores at 6 and 24 hours postoperatively in patients receiving magnesium sulfate vs. the control group. Secondary outcomes were postoperative opioid consumption, perioperative complications, and time to rescue analgesia.

Methods

A comprehensive database search identified studies comparing magnesium sulfate with control in adults undergoing general anesthesia for general abdominal surgery. Using random-effects models, data were presented as mean ± Standard Deviation (SD) or Odds Ratios (OR) with corresponding 95% Confidence Intervals (95% CI). A two-sided p-value < 0.05 was considered statistically significant.

Results

In total, 31 studies involving 1762 participants met the inclusion criteria. The magnesium group showed significantly lower postoperative pain scores at both early (within six hours) and late (up to 24 hours) time points compared to the control group. The early mean score was 3.1 ± 1.4 vs. 4.2 ± 2.3, and the late mean score was 2.3 ± 1.1 vs. 2.7 ± 1.5, resulting in an overall Mean Difference (MD) of −0.72; 95% CI −0.99, −0.44; p < 0.00001. The magnesium group was associated with lower rates of postoperative opioid consumption and shivering and had a longer time to first analgesia administration compared to the saline control group.