Emergency and Critical Care Center, Kurashiki Central Hospital, Miwa, Kurashiki, Okayama, 710-8602, Japan.
Department of Emergency Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Fukui, Japan.
Can J Anaesth. 2019 Sep;66(9):1082-1094. doi: 10.1007/s12630-019-01396-7. Epub 2019 May 22.
Postoperative sore throat negatively affects patient satisfaction and recovery. We conducted a systematic review and meta-analysis to examine the efficacy of preoperative topical administration of magnesium sulfate in preventing postoperative sore throat in adult patients.
We searched Medline, EMBASE, China National Knowledge Infrastructure, and the Cochrane Central Register of Controlled Trials from inception to 6 October, 2018. We included randomized-controlled trials that assessed the efficacy and safety of topical application of magnesium preoperatively in adult patients who underwent endotracheal intubation for general anesthesia. We then pooled the data using a random-effects model and conducted a trial sequential analysis on the incidence of sore throat. Our primary outcome was the incidence of sore throat at 24 hr after surgery/extubation. Our secondary outcomes included the severity of sore throat at 24 hr after surgery/extubation and adverse events.
Eleven randomized-controlled trials involving 1,096 patients were included in this study. Topical application of magnesium was associated with reduced incidence of postoperative sore throat (risk ratio, 0.31; 95% confidence interval [CI], 0.21 to 0.45) as well as reduced severity of postoperative sore throat (standardized mean difference, - 2.66; 95% CI, - 3.89 to - 1.43). Three studies reported that significant adverse events were not associated with topical magnesium. The trial sequential analysis suggested that there is adequate evidence supporting the efficacy of topical magnesium in preventing postoperative sore throat.
Our study suggests that preoperative topical magnesium can effectively prevent postoperative sore throat.
PROSPERO (CRD42018110019); registered 26 September, 2018.
术后咽喉痛会降低患者满意度和恢复速度。我们进行了一项系统评价和荟萃分析，以评估术前局部给予硫酸镁预防成人患者术后咽喉痛的疗效。
我们检索了 Medline、EMBASE、中国知网和 Cochrane 对照试验中心注册库，检索时间截至 2018 年 10 月 6 日。我们纳入了评估全麻下经气管插管的成年患者术前局部应用硫酸镁预防咽喉痛的疗效和安全性的随机对照试验。我们使用随机效应模型汇总数据，并对咽喉痛的发生率进行了试验序贯分析。我们的主要结局是术后/拔管后 24 小时咽喉痛的发生率。我们的次要结局包括术后/拔管后 24 小时咽喉痛的严重程度和不良事件。
本研究共纳入了 11 项随机对照试验，涉及 1096 名患者。与对照组相比，局部应用硫酸镁可降低术后咽喉痛的发生率（风险比，0.31；95%置信区间，0.21 至 0.45），降低术后咽喉痛的严重程度（标准化均数差，-2.66；95%置信区间，-3.89 至-1.43）。有 3 项研究报道，局部应用硫酸镁与显著不良事件无关。试验序贯分析表明，有足够的证据支持局部应用硫酸镁预防术后咽喉痛的疗效。
我们的研究表明，术前局部应用硫酸镁可有效预防术后咽喉痛。
PROSPERO（CRD42018110019）；注册于 2018 年 9 月 26 日。
