Ma Siguang, Zhang Yanju, Li Qian
Anesthesia Department, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin, China.
Tianjin Key Laboratory of Human Development and Reproductive Expansion, Tianjin, China.
Pain Pract. 2022 Jan;22(1):8-18. doi: 10.1111/papr.13022. Epub 2021 May 20.
The use of magnesium sulfate (MgSO ) as an adjunct in different anesthetic regimens for cesarean section (CS) delivery often reports conflicting results. This study aimed to review the effectiveness of MgSO on improving postoperative analgesia after CS systematically.
PubMed, Embase, and the Cochrane library were searched for randomized controlled trials (RCTs) published from inception to February 2020.
A total of 880 women were included (440 in each group). MgSO had a statistically significant effect compared to the control group on the highest VAS (weighted mean difference [WMD] = -0.74, 95% confidence interval [CI] = -1.03 to -0.46, p < 0.001, I = 91.7%, p < 0.001) and the last VAS (WMD = -0.47, 95% CI = -0.71 to -0.23, p < 0.001, I = 95.0%, p < 0.001). MgSO prolonged the time to the first use of analgesia compared to the control group (standardized mean difference [SMD] = -3.03 min, 95% CI = -4.32 to -1.74, p < 0.001, I = 96.3%, p < 0.001). MgSO decreased the consumption of analgesia compared to the control group (SMD = -3.20 mg of IV morphine equivalent, 95% CI: -5.45 to -0.95, p = 0.005, I = 97.6%, p < 0.001).
MgSO decreases the highest VAS in women who underwent general anesthesia, spinal anesthesia, or epidural for CS (all p < 0.05). Additional MgSO significantly reduces postoperative pain in women undergoing CS.
硫酸镁（MgSO）作为剖宫产（CS）不同麻醉方案的辅助用药，其效果报道往往相互矛盾。本研究旨在系统评价MgSO对改善CS术后镇痛的有效性。
检索PubMed、Embase和Cochrane图书馆中从创刊至2020年2月发表的随机对照试验（RCT）。
共纳入880名女性（每组440名）。与对照组相比，MgSO在最高视觉模拟评分（VAS）上有统计学显著效果（加权平均差[WMD]= -0.74，95%置信区间[CI]= -1.03至-0.46，p<0.001，I²=91.7%，p<0.001）以及末次VAS（WMD= -0.47，95%CI= -0.71至-0.23，p<0.001，I²=95.0%，p<0.001）。与对照组相比，MgSO延长了首次使用镇痛药的时间（标准化平均差[SMD]= -3.03分钟，95%CI= -4.32至-1.74，p<0.001，I²=96.3%，p<0.001）。与对照组相比，MgSO减少了镇痛药的消耗量（SMD= -3.20毫克静脉注射吗啡当量，95%CI：-5.45至-0.95，p=0.005，I²=97.6%，p<0.001）。
MgSO可降低接受全身麻醉、脊髓麻醉或硬膜外麻醉进行CS的女性的最高VAS（均p<0.05）。额外使用MgSO可显著减轻接受CS的女性的术后疼痛。
