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关节镜手术后单次关节内注射镁的镇痛效果和安全性:系统评价和荟萃分析。

Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis.

机构信息

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.

出版信息

Sci Rep. 2016 Nov 30;6:38024. doi: 10.1038/srep38024.


DOI:10.1038/srep38024
PMID:27901095
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5128786/
Abstract

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.

摘要

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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引用本文的文献

[1]
Effectiveness and impact of intravenous magnesium sulfate in spinal surgery systematic review and meta-analysis.

Front Pharmacol. 2025-6-18

[2]
Efficacy and Safety of Intravenous Magnesium Sulfate in Spinal Surgery: A Systematic Review and Meta-Analysis.

J Clin Med. 2024-5-26

[3]
Perioperative Magnesium for Postoperative Analgesia: An Umbrella Review of Systematic Reviews and Updated Meta-Analysis of Randomized Controlled Trials.

J Pers Med. 2021-12-2

[4]
The effect of magnesium added to bupivacaine for arthroscopy: a meta-analysis of randomized controlled trials.

J Orthop Surg Res. 2021-10-10

[5]
Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective.

Front Pharmacol. 2021-1-29

[6]
Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a Bayesian network meta-analysis protocol.

BMJ Open. 2020-9-17

[7]
Comparison of Efficacy of Intra-Articular Plain Bupivacaine and Bupivacaine with Adjuvants (Dexmedetomidine and Magnesium Sulfate) for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Prospective, Randomized Controlled Trial.

Anesth Essays Res. 2018

[8]
[Study on the protective mechanism of autophagy on cartilage by magnesium sulfate].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018-10-15

[9]
Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis.

BMJ Open. 2018-12-14

[10]
Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis.

Arthritis Res Ther. 2017-10-24

本文引用的文献

[1]
Articular cartilage and local anaesthetic: A systematic review of the current literature.

J Orthop. 2015-10-31

[2]
Minimum Effective Concentration of Bupivacaine in Ultrasound-Guided Femoral Nerve Block after Arthroscopic Knee Meniscectomy: A Randomized, Double-Blind, Controlled Trial.

Pain Physician. 2016-1

[3]
A Single-Dose Intra-Articular Morphine plus Bupivacaine versus Morphine Alone following Knee Arthroscopy: A Systematic Review and Meta-Analysis.

PLoS One. 2015-10-16

[4]
Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.

Knee Surg Sports Traumatol Arthrosc. 2017-3

[5]
The Analgesic Effects of Morphine and Tramadol Added to Intra-articular Levobupivacaine-Tenoxicam Combination for Arthroscopic Knee Surgery on Postoperative Pain; a Randomized Clinical Trial.

Anesth Pain Med. 2015-6-22

[6]
Magnesium and Ketamine Gargle and Postoperative Sore Throat.

Anesth Pain Med. 2015-6-22

[7]
Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies.

BMJ Open. 2015-6-15

[8]
Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc. 2016-5

[9]
Relationship between Serum Magnesium Concentration and Radiographic Knee Osteoarthritis.

J Rheumatol. 2015-7

[10]
Association between Dietary Magnesium Intake and Radiographic Knee Osteoarthritis.

PLoS One. 2015-5-26

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