Abstract：
BACKGROUND: Laryngospasm is sustained closure of the airways and can be a life-threatening condition. Magnesium sulphate is postulated to reduce the incidence of laryngospasm if administered peri-operatively. This systematic review and meta-analysis was performed to assess the efficacy of magnesium sulphate in preventing peri-operative laryngospasm in paediatric patients undergoing non-cardiac surgery.
METHODS: Four databases and a trial registry were searched. Inclusion criteria were paediatric patients undergoing general anaesthesia. Exclusion criteria were patients who underwent cardiopulmonary bypass during surgery. The intervention of interest was the peri-operative administration of magnesium sulphate. The intervention was compared to either a placebo or other pharmacological agent. The primary outcome was the incidence of laryngospasm. A meta-analysis of all studies was performed. Sub-group analysis was subsequently performed.
RESULTS: A total of 953 patients from 13 trials were included in this study. Nine RCTs administered magnesium intravenously and 4 RCTs administered magnesium locally. Laryngospasm rates were 6% lower in the magnesium group (OR 0.48 [95% CI 0.25-0.96], p = 0.04) compared to control in the pooled data. Subgroup analysis showed laryngospasm rates were lower by 12.5% (Odds Ratio 0.26 [CI 0.09-0.76], p = 0.01) in the local magnesium group. Subgroup analysis of studies that only administered intravenous magnesium did not show a statistically significant difference in the incidence of laryngospasm (OR 0.73 [95% CI 0.33-1.63], p = 0.44).
CONCLUSIONS: This review shows a potential role for magnesium in the prevention of laryngospasm in paediatric patients undergoing general anaesthesia. There is a correlation between local administration of magnesium and reduction in laryngospasm rates. Further studies are required to assess the efficacy of intravenous magnesium in prevention of laryngospasm.
BACKGROUND: Prospective Register of Systematic Reviews (PROSPERO); PROSPERO ID CRD42022307868 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022307868).
METHODS: Four databases and a trial registry were searched. Inclusion criteria were paediatric patients undergoing general anaesthesia. Exclusion criteria were patients who underwent cardiopulmonary bypass during surgery. The intervention of interest was the peri-operative administration of magnesium sulphate. The intervention was compared to either a placebo or other pharmacological agent. The primary outcome was the incidence of laryngospasm. A meta-analysis of all studies was performed. Sub-group analysis was subsequently performed.
RESULTS: A total of 953 patients from 13 trials were included in this study. Nine RCTs administered magnesium intravenously and 4 RCTs administered magnesium locally. Laryngospasm rates were 6% lower in the magnesium group (OR 0.48 [95% CI 0.25-0.96], p = 0.04) compared to control in the pooled data. Subgroup analysis showed laryngospasm rates were lower by 12.5% (Odds Ratio 0.26 [CI 0.09-0.76], p = 0.01) in the local magnesium group. Subgroup analysis of studies that only administered intravenous magnesium did not show a statistically significant difference in the incidence of laryngospasm (OR 0.73 [95% CI 0.33-1.63], p = 0.44).
CONCLUSIONS: This review shows a potential role for magnesium in the prevention of laryngospasm in paediatric patients undergoing general anaesthesia. There is a correlation between local administration of magnesium and reduction in laryngospasm rates. Further studies are required to assess the efficacy of intravenous magnesium in prevention of laryngospasm.
BACKGROUND: Prospective Register of Systematic Reviews (PROSPERO); PROSPERO ID CRD42022307868 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022307868).
摘要：
背景：喉痉挛是气道的持续闭合，可能是一种危及生命的疾病。如果围手术期给予硫酸镁，可以降低喉痉挛的发生率。这项系统评价和荟萃分析旨在评估硫酸镁预防非心脏手术儿科患者围手术期喉痉挛的疗效。
方法：检索了四个数据库和一个试验注册。纳入标准为接受全身麻醉的儿科患者。排除标准为手术期间接受体外循环的患者。感兴趣的干预措施是围手术期施用硫酸镁。将干预措施与安慰剂或其他药物进行比较。主要结果是喉痉挛的发生率。对所有研究进行荟萃分析。随后进行亚组分析。
结果：本研究共纳入13项试验的953名患者。9个RCT静脉内给予镁，4个RCT局部给予镁。镁组喉痉挛发生率低6%(OR0.48[95%CI0.25-0.96],p=0.04)与池化数据中的对照相比。亚组分析显示喉痉挛发生率降低12.5%(赔率0.26[CI0.09-0.76]，局部镁组p=0.01)。仅静脉注射镁的研究的亚组分析未显示喉痉挛发生率的统计学显着差异（OR0.73[95％CI0.33-1.63]，p=0.44）。
结论：这篇综述显示了镁在预防接受全身麻醉的儿科患者喉痉挛中的潜在作用。局部施用镁与喉痉挛发生率降低之间存在相关性。需要进一步的研究来评估静脉注射镁预防喉痉挛的功效。
背景：前瞻性系统评论注册（PROSPERO）；PROSPEROIDCRD42022307868（https：//www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022307868)。
方法：检索了四个数据库和一个试验注册。纳入标准为接受全身麻醉的儿科患者。排除标准为手术期间接受体外循环的患者。感兴趣的干预措施是围手术期施用硫酸镁。将干预措施与安慰剂或其他药物进行比较。主要结果是喉痉挛的发生率。对所有研究进行荟萃分析。随后进行亚组分析。
结果：本研究共纳入13项试验的953名患者。9个RCT静脉内给予镁，4个RCT局部给予镁。镁组喉痉挛发生率低6%(OR0.48[95%CI0.25-0.96],p=0.04)与池化数据中的对照相比。亚组分析显示喉痉挛发生率降低12.5%(赔率0.26[CI0.09-0.76]，局部镁组p=0.01)。仅静脉注射镁的研究的亚组分析未显示喉痉挛发生率的统计学显着差异（OR0.73[95％CI0.33-1.63]，p=0.44）。
结论：这篇综述显示了镁在预防接受全身麻醉的儿科患者喉痉挛中的潜在作用。局部施用镁与喉痉挛发生率降低之间存在相关性。需要进一步的研究来评估静脉注射镁预防喉痉挛的功效。
背景：前瞻性系统评论注册（PROSPERO）；PROSPEROIDCRD42022307868（https：//www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022307868)。
