Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
J Pain. 2023 Jul;24(7):1151-1162. doi: 10.1016/j.jpain.2023.02.031. Epub 2023 Mar 4.
Peripheral magnetic stimulation (PMS) is a potentially promising modality to help manage postoperative pain. We systematically reviewed the effect of PMS on acute and chronic postoperative pain. MEDLINE, Cochrane CENTRAL, EMBASE, ProQuest Dissertations, and clinical trials.gov were searched from inception until May 2021. We included studies of any study design that included patients ≥18 years of age undergoing any type of surgery that administered PMS within the perioperative period and evaluated postoperative pain. Seventeen randomized controlled trials and 1 nonrandomized clinical trial were included into the review. Thirteen out of the 18 studies found a positive effect with PMS on postoperative pain scores. In our meta-analysis, peripheral magnetic stimulation was more efficacious than sham or no intervention within the first 7 postoperative days (mean difference [MD] -1.64 on a 0 to 10 numerical rating score, 95% confidence interval [CI] -2.08 to -1.20, I = 77%, 6 studies, 231 patients). This was also true at 1 and 2 months after surgery (MD -1.82, 95% CI -2.48 to -1.17, I = 0%, 3 studies, 104 patients; and MD -1.96, 95% CI -3.67 to -.26, I = 84%, 3 studies, 104 patients, respectively). A difference was not seen with persistent pain at 6 and 12-months after surgery, acute postoperative opioid consumption, or adverse events between groups. Results are limited by heterogeneity and generally low-quality studies, as well as low or very low quality of evidence. High-quality and adequately blinded trials are needed to definitively confirm the benefits of peripheral magnetic stimulation administered in the perioperative period. PERSPECTIVE: This review evaluates the efficacy and safety of PMS on postoperative pain. The results help elucidate PMS' role in postoperative pain management and identify gaps where more research is required.
外周磁刺激（PMS）是一种有潜力的治疗方法，可以帮助管理术后疼痛。我们系统地回顾了 PMS 对急性和慢性术后疼痛的影响。我们检索了 MEDLINE、Cochrane 中心、EMBASE、ProQuest Dissertations 和 clinicaltrials.gov 从建库到 2021 年 5 月的所有文献。我们纳入了任何研究设计的研究，这些研究纳入了年龄≥18 岁、接受围手术期内 PMS 治疗并评估术后疼痛的任何类型手术的患者。共有 17 项随机对照试验和 1 项非随机临床试验纳入了本次综述。在 18 项研究中，有 13 项研究发现 PMS 对术后疼痛评分有积极影响。在我们的荟萃分析中，在术后 7 天内，外周磁刺激比假刺激或无干预更有效（0 到 10 数字评分的平均差值为-1.64，95%置信区间为-2.08 到-1.20，I²=77%，6 项研究，231 例患者）。在术后 1 个月和 2 个月时也是如此（MD-1.82，95%CI-2.48 到-1.17，I²=0%，3 项研究，104 例患者；MD-1.96，95%CI-3.67 到-.26，I²=84%，3 项研究，104 例患者）。在术后 6 个月和 12 个月的持续性疼痛、急性术后阿片类药物消耗或组间不良事件方面，没有差异。结果受到异质性和一般低质量研究以及低或极低质量证据的限制。需要高质量和充分盲法的试验来明确证实围手术期外周磁刺激的益处。观点：本综述评估了 PMS 对术后疼痛的疗效和安全性。结果有助于阐明 PMS 在术后疼痛管理中的作用，并确定需要进一步研究的领域。
