Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China.
Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China.
Sci Rep. 2016 Nov 30;6:38024. doi: 10.1038/srep38024.
To examine the analgesic effect and safety of single-dose intra-articular (IA) magnesium (Mg) after arthroscopic surgery. Pubmed, Embase and Cochrane library were searched through in January 2016. Eight RCTs and eight experimental studies were included. The IA Mg exhibited a significantly lower pain score when compared with placebo (MD, -0.41, 95% CI, -0.78 to -0.05, p = 0.03). There was no significant difference between Mg and bupivacaine in terms of pain relief and the time to first analgesic request. Furthermore, statistically significant differences both in pain score (MD, -0.62, 95% CI, -0.81 to -0.42, p < 0.00001) and time to first analgesic request (MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001) were observed between Mg plus bupivacaine and bupivacaine alone. There was no statistically significant difference among the various groups with respect to adverse reactions. Most of the included in vitro studies reported the chondrocyte protective effect of Mg supplementation. There were also two in vivo studies showing the cartilage protective effect of IA Mg. The single-dose IA Mg following arthroscopic surgery was effective in pain relief without increasing adverse reactions, and it could also enhance the analgesic effect of bupivacaine. In addition, Mg seemed to possess the cartilage or chondrocyte protective effect based on experimental studies.
目的:评估关节镜术后单次关节内(IA)镁(Mg)的镇痛效果和安全性。
检索策略:检索 2016 年 1 月的 PubMed、Embase 和 Cochrane 图书馆。
纳入标准:随机对照试验(RCT)和实验研究。
排除标准:非英语文献、重复研究、综述、病例报告、动物研究、体外研究、非关节内应用 Mg 及 Mg 与其他药物联合应用但未单独评估 Mg 作用的研究。
文献筛选和资料提取:两名评价者独立筛选文献、提取资料并交叉核对。
纳入 8 项 RCT 和 8 项实验研究。与安慰剂相比,IA Mg 组疼痛评分显著降低(MD,-0.41,95%CI,-0.78 至-0.05,p=0.03)。在镇痛效果和首次需要镇痛药物的时间方面,Mg 与布比卡因之间无显著差异。此外,Mg 联合布比卡因组在疼痛评分(MD,-0.62,95%CI,-0.81 至-0.42,p<0.00001)和首次需要镇痛药物的时间(MD,6.25,95%CI,5.22 至 7.29,p<0.00001)方面均显著优于布比卡因组。各组间不良反应发生率无统计学差异。大多数纳入的体外研究报道了 Mg 补充剂对软骨细胞的保护作用,也有 2 项体内研究显示了 IA Mg 对软骨的保护作用。关节镜术后单次 IA Mg 可有效缓解疼痛而不增加不良反应,还可增强布比卡因的镇痛效果。此外,基于实验研究,Mg 似乎具有软骨或软骨细胞保护作用。
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