Wang Jinguo, Wang Zaitang, Shi Bo, Wang Na
Department of Urology, the First Hospital of Jilin University, Changchun, Jilin.
Department of Taxation, School of Public Economics and Administration of Shanghai University of Finance and Economics, Shanghai.
Medicine (Baltimore). 2020 Oct 2;99(40):e22524. doi: 10.1097/MD.0000000000022524.
The current study is a meta-analysis designed to assess the effect of adding magnesium to a combination of intrathecal bupivacaine and fentanyl.
The protocol was registered in PROSPERO with the number CRD42020177618. PubMed, Cochrane library, Web of Science, and Google Scholar were searched for randomized controlled trials investigating the effect of adding magnesium to a combination of intrathecal bupivacaine and fentanyl. The continuous data were presented as Ratio of means (RoM). Risk ratio (RR) along with 95% confidence interval (CI) was utilized to assess the dichotomous data.
Ten trials were involved in the present study with 720 adult patients. Compared with control, intrathecal magnesium prolonged time to the first analgesic requirement by an estimate of 1.23 (RoM: 1.23; 95%CI: 1.13-1.33; P < .00001), prolonged adequate sensory block duration for surgery by an estimate of 1.16 (RoM: 1.16; 95%CI: 1.05-1.27; P = .003), delayed time to maximum sensory level by an estimate of 1.38 (RoM: 1.38; 95%CI: 1.07-1.78; P = .01) and reduced the incidence of shivering following spinal anesthesia (risk ratio: 0.38; 95%CI: 0.18 to 0.81, P = .01) without influence on time to full motor recovery or incidences of hypotention, bradycardia, nausea, and vomiting or pruritis.
Intrathecal magnesium, when added to a combination of intrathecal bupivacaine and fentany, prolongs the analgesic duration of spinal anesthesia without increased incidences of side effects.
本研究为一项荟萃分析，旨在评估在鞘内注射布比卡因和芬太尼的联合用药中添加镁的效果。
该方案已在国际前瞻性注册系统（PROSPERO）上注册，注册号为CRD42020177618。通过检索PubMed、考克兰图书馆、科学网和谷歌学术，查找有关在鞘内注射布比卡因和芬太尼的联合用药中添加镁的效果的随机对照试验。连续数据以均值比（RoM）表示。风险比（RR）及95%置信区间（CI）用于评估二分数据。
本研究纳入了10项试验，共720例成年患者。与对照组相比，鞘内注射镁可使首次需要镇痛的时间延长，估计延长1.23倍（RoM：1.23；95%CI：1.13 - 1.33；P < 0.00001），使手术所需的充分感觉阻滞时间延长，估计延长1.16倍（RoM：1.16；95%CI：1.05 - 1.27；P = 0.003），使达到最大感觉平面的时间延迟，估计延迟1.38倍（RoM：1.38；95%CI：1.07 - 1.78；P = 0.01），并降低脊髓麻醉后寒战的发生率（风险比：0.38；95%CI：0.18至0.81，P = 0.01），而对完全运动恢复时间或低血压、心动过缓、恶心、呕吐或瘙痒的发生率无影响。
在鞘内注射布比卡因和芬太尼的联合用药中添加鞘内注射镁，可延长脊髓麻醉的镇痛持续时间，且不增加副作用的发生率。
