PDF(Pubmed)
Abstract：
Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies (n = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD -0.20, 95% CI: -0.39 to -0.02) and opioid consumption (SMD -0.66, 95% CI: -0.95 to -0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD -0.91, 95% CI: -1.65 to -0.17) and remifentanil (SMD -1.52, 95% CI: -1.98 to -1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups.
摘要：
优化脊柱手术中的疼痛管理对于预防由于延迟动员引起的不良事件至关重要。硫酸镁由于其镇痛特性和调节神经递质和自主神经系统而在脊柱手术中具有潜在的益处。关于使用硫酸镁的现有证据是部分和有争议的，需要进行全面的荟萃分析来评估其疗效和安全性。这项研究的目的是进行全面的荟萃分析，以评估硫酸镁在脊柱手术中与其他可用选择相比的有效性和安全性。这项荟萃分析遵循PRISMA指南。包括接受脊柱手术的患者，干预组接受各种剂量或组合的静脉注射硫酸镁（MS），而对照组则接受其他替代方案或安慰剂.评估疗效和安全性结果。从多个数据库收集数据并使用ReviewManager版本5.4进行分析。评估异质性，并应用固定或随机效应模型。荟萃分析包括8项研究(n=541)。与安慰剂相比，硫酸镁显示24h疼痛（MD-0.20，95％CI：-0.39至-0.02）和阿片类药物消耗（SMD-0.66，95％CI：-0.95至-0.38）显着减轻。此外,观察到肌肉松弛剂(SMD-0.91,95%CI:-1.65~-0.17)和瑞芬太尼(SMD-1.52,95%CI:-1.98~-1.05)的使用减少.相比之下,与右美托咪定相比,观察到拔管时间(MD2.42,95%CI:1.14~3.71)和言语反应(MD1.85,95%CI:1.13~2.58)增加.总之,在脊柱手术中使用硫酸镁可以减少疼痛和阿片类药物的消耗，以及长时间的定向和口头反应。两组之间的血压或心率没有显着差异。
