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The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials

INTRODUCTION: The aim of this systematic review is to investigate the effects of perioperative intravenous administration of MgSO(4) on postoperative pain, analgesic consumption and adverse effects in patients undergoing orthopedic surgery. METHODS: Two investigators independently searched for artic...

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Autores principales: Peng, Yu-Ning, Sung, Fung-Chang, Huang, Mei-Li, Lin, Cheng-Li, Kao, Chia-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319973/
https://www.ncbi.nlm.nih.gov/pubmed/30558026
http://dx.doi.org/10.1097/MD.0000000000013583
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author Peng, Yu-Ning
Sung, Fung-Chang
Huang, Mei-Li
Lin, Cheng-Li
Kao, Chia-Hung
author_facet Peng, Yu-Ning
Sung, Fung-Chang
Huang, Mei-Li
Lin, Cheng-Li
Kao, Chia-Hung
author_sort Peng, Yu-Ning
collection PubMed
description INTRODUCTION: The aim of this systematic review is to investigate the effects of perioperative intravenous administration of MgSO(4) on postoperative pain, analgesic consumption and adverse effects in patients undergoing orthopedic surgery. METHODS: Two investigators independently searched for articles on randomized controlled trials (RCTs) from 1998 to 2016 in Pubmed, Web of science and Google scholar. We evaluated clinical outcomes, comparing postoperative pain scores, cumulative analgesic consumption, time to first analgesia, and adverse effects between orthopedic surgery patients with and without the administration of MgSO(4). RESULTS: After screening 2350 articles, 11 RCTs (with a total sample size of 535 subjects) were included in this systematic review. Perioperative intravenous administered MgSO(4) could reduce postoperative pain intensity compared with control in 6 trials (55%), but without significant difference in 5 trials (45%). With MgSO(4) treatments, postoperative analgesic consumption was significantly reduced in 8 trials (73%), and without significant difference in 2 trials (18%). Two trials evaluated the time to first request of analgesic after surgery and showed prolong of 2.3 hours and 93 minutes respectively. MgSO(4) group had less postoperative nausea (relative risk [RR] = 0.32, 95% confidence interval [CI] = 0.12–0.82, number needed to harm [NNH] = 8.8), vomiting (RR = 0.38, 95% CI = 0.15–0.92, NNH = 9.7), and shivering (RR = 0.31, 95% CI = 0.11–0.88, NNH = 5.2). CONCLUSION: Perioperative intravenous administration of MgSO(4) in orthopedic surgery could reduce postoperative analgesic consumption and adverse effects such as vomiting, nausea, and shivering. These trials do not provide convincing evidence of beneficial effects on postoperative pain intensity and the time to first analgesic request. More trials should be conducted for the roles of MgSO(4) in pain management for orthopedic surgery. However, intravenous MgSO(4) administration should be considered as a strategy to relieve postoperative pain in orthopedic surgery patients.
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spelling pubmed-63199732019-01-24 The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials Peng, Yu-Ning Sung, Fung-Chang Huang, Mei-Li Lin, Cheng-Li Kao, Chia-Hung Medicine (Baltimore) Research Article INTRODUCTION: The aim of this systematic review is to investigate the effects of perioperative intravenous administration of MgSO(4) on postoperative pain, analgesic consumption and adverse effects in patients undergoing orthopedic surgery. METHODS: Two investigators independently searched for articles on randomized controlled trials (RCTs) from 1998 to 2016 in Pubmed, Web of science and Google scholar. We evaluated clinical outcomes, comparing postoperative pain scores, cumulative analgesic consumption, time to first analgesia, and adverse effects between orthopedic surgery patients with and without the administration of MgSO(4). RESULTS: After screening 2350 articles, 11 RCTs (with a total sample size of 535 subjects) were included in this systematic review. Perioperative intravenous administered MgSO(4) could reduce postoperative pain intensity compared with control in 6 trials (55%), but without significant difference in 5 trials (45%). With MgSO(4) treatments, postoperative analgesic consumption was significantly reduced in 8 trials (73%), and without significant difference in 2 trials (18%). Two trials evaluated the time to first request of analgesic after surgery and showed prolong of 2.3 hours and 93 minutes respectively. MgSO(4) group had less postoperative nausea (relative risk [RR] = 0.32, 95% confidence interval [CI] = 0.12–0.82, number needed to harm [NNH] = 8.8), vomiting (RR = 0.38, 95% CI = 0.15–0.92, NNH = 9.7), and shivering (RR = 0.31, 95% CI = 0.11–0.88, NNH = 5.2). CONCLUSION: Perioperative intravenous administration of MgSO(4) in orthopedic surgery could reduce postoperative analgesic consumption and adverse effects such as vomiting, nausea, and shivering. These trials do not provide convincing evidence of beneficial effects on postoperative pain intensity and the time to first analgesic request. More trials should be conducted for the roles of MgSO(4) in pain management for orthopedic surgery. However, intravenous MgSO(4) administration should be considered as a strategy to relieve postoperative pain in orthopedic surgery patients. Wolters Kluwer Health 2018-12-14 /pmc/articles/PMC6319973/ /pubmed/30558026 http://dx.doi.org/10.1097/MD.0000000000013583 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Peng, Yu-Ning
Sung, Fung-Chang
Huang, Mei-Li
Lin, Cheng-Li
Kao, Chia-Hung
The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title_full The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title_fullStr The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title_full_unstemmed The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title_short The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials
title_sort use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: a systematic review of randomized controlled trials
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319973/
https://www.ncbi.nlm.nih.gov/pubmed/30558026
http://dx.doi.org/10.1097/MD.0000000000013583
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