Chen Liang-Fu, Yang Chih-Hao, Lin Ting-Yi, Pao Po-Jia, Chu Karen Chia-Wen, Hsu Chin-Wang, Bai Chyi-Huey, Du Ming-Hai, Hsu Yuan-Pin
Emergency Department, Wan Fang Hospital, Taipei Medical University.
Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University.
Medicine (Baltimore). 2020 Nov 13;99(46):e23279. doi: 10.1097/MD.0000000000023279.
Magnesium sulfate (MgSO4) is widely used in analgesia for different conditions. Recent randomized controlled trials (RCTs) have evaluated the effects of MgSO4 on renal colic; however, this new evidence has not been synthesized. Thus, we conducted a systematic review and meta-analysis to assess the efficacy and safety of MgSO4 in comparison with control for renal colic.
PubMed, EMBASE, and Scopus databases were searched from inception to February 2020. We included RCTs that evaluated MgSO4 vs control for patients with renal colic. Data were independently extracted by 2 reviewers and synthesized using a random-effects model.
Four studies with a total of 373 patients were analyzed. Intravenous MgSO4 15 to 50 mg/kg did not significantly reduce renal colic pain severity at 15 minutes (mean difference [MD] = 0.35, 95% confidence interval [CI] -0.51 to 1.21; 2 RCTs), 30 minutes (MD = 0.19, 95% CI -0.74 to 1.13; 4 RCTs), and 60 minutes (MD = -0.28, 95% CI -0.72 to 0.16; 3 RCTs) in comparison with controls. In patients who failed to respond to initial analgesics, intravenous MgSO4 15 mg/kg or 2 ml of 50% solution provided similar pain relief to ketorolac or morphine at 30 minutes (P = .90) and 60 minutes (P = .57). No significant hemodynamic changes were observed with short-term use of MgSO4 in these studies.
MgSO4 provides no superior therapeutic benefits in comparison with control treatments. MgSO4 may be used as a rescue medication in patients not responding to initial analgesics. The short-term use of MgSO4 did not affect hemodynamic values.
硫酸镁（MgSO4）广泛用于不同情况下的镇痛。近期的随机对照试验（RCT）评估了MgSO4对肾绞痛的影响；然而，尚未对这些新证据进行综合分析。因此，我们进行了一项系统评价和荟萃分析，以评估MgSO4与对照组相比治疗肾绞痛的疗效和安全性。
检索了从数据库建立至2020年2月的PubMed、EMBASE和Scopus数据库。我们纳入了评估MgSO4与对照组治疗肾绞痛患者的RCT。数据由两名研究者独立提取，并采用随机效应模型进行综合分析。
分析了4项研究，共373例患者。与对照组相比，静脉注射15至50mg/kg的MgSO4在15分钟（平均差[MD]=0.35，95%置信区间[CI]-0.51至1.21；2项RCT）、30分钟（MD=0.19，95%CI-0.74至1.13；4项RCT）和60分钟（MD=-0.28，95%CI-0.72至0.16；3项RCT）时，并未显著降低肾绞痛的疼痛严重程度。在对初始镇痛药无反应的患者中，静脉注射15mg/kg的MgSO4或2ml 50%溶液在30分钟（P=0.90）和60分钟（P=0.57）时提供的疼痛缓解与酮咯酸或吗啡相似。在这些研究中，短期使用MgSO4未观察到明显的血流动力学变化。
与对照治疗相比，MgSO4没有更好的治疗效果。MgSO4可作为对初始镇痛药无反应患者的抢救药物。短期使用MgSO4不影响血流动力学值。
