Effects of Systemic Magnesium on Postoperative Analgesia: Is the Current Evidence Strong Enough?
Background: Clinical studies have been previously carried out on the efficacy of systemic magnesium to minimize postoperative pain, however, with controversial results. A quantitative meta-analysis was performed to evaluate the analgesic efficacy and safety of systemic magnesium on post-operative pa...
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Veröffentlicht in: | Pain physician 2015-09, Vol.5;18 (5;9), p.405-417 |
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Sprache: | eng |
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Zusammenfassung: | Background: Clinical studies have been previously carried out on the efficacy of systemic
magnesium to minimize postoperative pain, however, with controversial results. A quantitative
meta-analysis was performed to evaluate the analgesic efficacy and safety of systemic
magnesium on post-operative pain.
Study Design: Comprehensive systematic review of all relevant, publsished randomized
controlled trials.
Methods: A search was conducted of published literature in MEDLINE, PsycINFO, Scopus,
EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from
inception to September 2014. Randomized controlled trials (RCTs) that compared magnesium
with placebo were identified. Effects were summarized using standardized mean differences
(SMDs), weighed mean differences (WMD), or odds ratio (OR) with suitable effect model.
Results: Twenty-seven RCTs involving 1,504 patients were included. In total, peri-operative
magnesium significantly reduced the pain score at rest (SMD, -1.43, 95% CI, -2.74 to -0.12, <
0.01). Magnesium significantly reduced analgesic consumption (SMD, -1.72, 95% CI, -3.21 to
-0.23) in patients undergoing urogenital, orthopaedic, and cardiovascular surgeries, but was
inconclusive for patients receiving gastrointestinal surgeries. The obvious analgesia of systemic
magnesium was observed on reducing the pain score during movement at 24 hours after
operation (SMD, -0.05, 95% CI, -0.43 to 0.32). Moreover, magnesium administration showed
a beneficial effect with regard to intra-operative hemodynamics and reduced extubation time
in the cardiovascular surgery patients (WMD, -29.34 min, 95% CI, -35.74 to -22.94, P < 0.01).
Limitations: Focused only on the quality of analgesia on postoperative pain with regards to
surgery type.
Conclusions: Our study suggests that systemic magnesium during general anesthesia
significantly decreases post-operative pain scores without increasing adverse events. It should
be noted that since there are 18 ongoing RCTs without published data, it is still premature to
draw conclusions on the long-term analgesic effects of magnesium as well as potential gender
or age difference.
Key words: Magnesium, post-operative pain, meta-analysis |
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ISSN: | 1533-3159 2150-1149 |
DOI: | 10.36076/ppj.2015/18/405 |