目的:研究硫酸镁(MS)对成年手术患者全身麻醉(GA)后苏醒期躁动(EA)的影响。
方法:系统文献综述和荟萃分析(PROSPERO编号:CRD42023461988)。
方法:综述已发表的文献。
方法:成人接受GA。
方法:静脉注射MS。
方法:我们搜索了PubMed/MEDLINE,EMBASE,Cochrane图书馆,Scopus,和WebofScience的出版物,直到2023年9月14日。主要结果是EA的发生率,而次要结局包括MS对术后躁动评分(PAS)的影响,出现变量和不良事件。用95%置信区间(CI)测量二分结果的相对风险(RR),而标准平均差(SMD)或平均差(MD)与95%CI测量连续结局。
结果:五个随机对照试验(RCTs)的荟萃分析表明,MS在各个时间点与较低的EA发生率相关(0分钟:RR=0.62,95%CI[0.41,0.95];p=0.183,I2=43.6%;5分钟:RR=0.29,95%CI[0.16,0.52];p=0.211,95分钟CI=0.65%=0.此外,在除了0分钟以外的不同时间点,MS与降低的PAS相关。然而,拔管时间无显著差异,在麻醉后监护病房的住院时间,术后恶心呕吐或完全并发症。
结论:有限的现有证据表明MS与较低的EA发病率相关。然而,需要进一步的高质量研究来加强和验证MS在预防成年手术患者EA中的作用.
OBJECTIVE: Investigating the effect of magnesium sulfate (MS) on emergence agitation (EA) in adult surgical patients following general anesthesia (GA).
METHODS: Systematic literature review and meta-analysis (PROSPERO number: CRD42023461988).
METHODS: Review of published literature.
METHODS: Adults undergoing GA.
METHODS: Intravenous administration of MS.
METHODS: We searched PubMed/MEDLINE, EMBASE, the Cochrane Library, Scopus, and Web of Science for publications until September 14, 2023. The primary outcome was the incidence of EA, while the secondary outcomes included the impact of MS on postoperative agitation score (PAS), emergence variables and adverse events. Relative risk (RR) with 95% confidence interval (CI) measured dichotomous outcome, while standardized mean difference (SMD) or mean difference (MD) with 95% CI measured continuous outcomes.
RESULTS: Meta-analysis of five randomized controlled trials (RCTs) indicated that MS was associated with a lower incidence of EA at various time points (0 min: RR = 0.62, 95% CI [0.41, 0.95]; p = 0.183, I2 = 43.6%; 5 min: RR = 0.29, 95% CI [0.16, 0.52]; p = 0.211, I2 = 36%; 10 min: RR = 0.14, 95% CI [0.06, 0.32]; p = 0.449, I2 = 0%; 15 min: RR = 0.11, 95% CI [0.02, 0.55]; p = 0.265, I2 = 19.5%; 30 min: RR = 0.05, 95% CI [0.00, 0.91]; the postoperative period: RR = 0.21, 95% CI [0.09, 0.49]; p = 0.724, I2 = 0%;). Additionally, MS was associated with a reduced PAS at various time points except for 0 min. However, no significant differences were observed in extubation time, the length of stay in the post-anesthesia care unit, postoperative nausea and vomiting or total complications.
CONCLUSIONS: Limited available evidence suggests that MS was associated with a lower incidence of EA. Nevertheless, further high-quality studies are warranted to strengthen and validate the effect of MS in preventing EA in adult surgical patients.