Evidence-based Medicine Centre, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China; Institute for Hospital Management, Tsinghua University, Beijing 100084, China.
Evidence-based Medicine Centre, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China.
J Clin Anesth. 2024 Sep;96:111499. doi: 10.1016/j.jclinane.2024.111499. Epub 2024 May 14.
Investigating the effect of magnesium sulfate (MS) on emergence agitation (EA) in adult surgical patients following general anesthesia (GA).
Systematic literature review and meta-analysis (PROSPERO number: CRD42023461988).
Review of published literature.
Adults undergoing GA.
Intravenous administration of MS.
We searched PubMed/MEDLINE, EMBASE, the Cochrane Library, Scopus, and Web of Science for publications until September 14, 2023. The primary outcome was the incidence of EA, while the secondary outcomes included the impact of MS on postoperative agitation score (PAS), emergence variables and adverse events. Relative risk (RR) with 95% confidence interval (CI) measured dichotomous outcome, while standardized mean difference (SMD) or mean difference (MD) with 95% CI measured continuous outcomes.
Meta-analysis of five randomized controlled trials (RCTs) indicated that MS was associated with a lower incidence of EA at various time points (0 min: RR = 0.62, 95% CI [0.41, 0.95]; p = 0.183, I = 43.6%; 5 min: RR = 0.29, 95% CI [0.16, 0.52]; p = 0.211, I = 36%; 10 min: RR = 0.14, 95% CI [0.06, 0.32]; p = 0.449, I = 0%; 15 min: RR = 0.11, 95% CI [0.02, 0.55]; p = 0.265, I = 19.5%; 30 min: RR = 0.05, 95% CI [0.00, 0.91]; the postoperative period: RR = 0.21, 95% CI [0.09, 0.49]; p = 0.724, I = 0%;). Additionally, MS was associated with a reduced PAS at various time points except for 0 min. However, no significant differences were observed in extubation time, the length of stay in the post-anesthesia care unit, postoperative nausea and vomiting or total complications.
Limited available evidence suggests that MS was associated with a lower incidence of EA. Nevertheless, further high-quality studies are warranted to strengthen and validate the effect of MS in preventing EA in adult surgical patients.
研究硫酸镁（MS）对全身麻醉（GA）后成年手术患者苏醒期躁动（EA）的影响。
系统文献回顾和荟萃分析（PROSPERO 编号：CRD42023461988）。
文献综述。
接受 GA 的成年人。
静脉内给予 MS。
我们检索了 PubMed/MEDLINE、EMBASE、Cochrane 图书馆、Scopus 和 Web of Science，以获取截至 2023 年 9 月 14 日的出版物。主要结局是 EA 的发生率，次要结局包括 MS 对术后躁动评分（PAS）、苏醒变量和不良事件的影响。相对风险（RR）和 95%置信区间（CI）用于衡量二分类结局，而标准化均数差（SMD）或均数差（MD）和 95%CI 用于衡量连续结局。
对五项随机对照试验（RCT）的荟萃分析表明，MS 与不同时间点的 EA 发生率较低相关（0 分钟：RR=0.62，95%CI[0.41，0.95]；p=0.183，I=43.6%；5 分钟：RR=0.29，95%CI[0.16，0.52]；p=0.211，I=36%；10 分钟：RR=0.14，95%CI[0.06，0.32]；p=0.449，I=0%；15 分钟：RR=0.11，95%CI[0.02，0.55]；p=0.265，I=19.5%；30 分钟：RR=0.05，95%CI[0.00，0.91]；术后：RR=0.21，95%CI[0.09，0.49]；p=0.724，I=0%）。此外，MS 与不同时间点的 PAS 降低相关，但除了 0 分钟，MS 与拔管时间、麻醉后护理单元停留时间、术后恶心和呕吐或总并发症无显著差异。
有限的现有证据表明，MS 与 EA 发生率降低相关。然而，需要进一步的高质量研究来加强和验证 MS 在预防成年手术患者 EA 中的作用。
