Campos Jorge, Bas Jose Luis, Campos Claudia, Mariscal Gonzalo, Bas Teresa, Bas Paloma
Spine Unit, Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain.
Son Espases University Hospital, 07120 Palma de Mallorca, Spain.
J Clin Med. 2024 May 26;13(11):3122. doi: 10.3390/jcm13113122.
Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies ( = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD -0.20, 95% CI: -0.39 to -0.02) and opioid consumption (SMD -0.66, 95% CI: -0.95 to -0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD -0.91, 95% CI: -1.65 to -0.17) and remifentanil (SMD -1.52, 95% CI: -1.98 to -1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups.
优化脊柱手术中的疼痛管理对于预防因活动延迟导致的不良事件至关重要。硫酸镁因其镇痛特性以及对神经递质和自主神经系统的调节作用，在脊柱手术中具有潜在益处。关于硫酸镁使用的现有证据不完整且存在争议，因此需要进行全面的荟萃分析来评估其疗效和安全性。本研究的目的是进行一项全面的荟萃分析，以评估与其他可用选项相比，硫酸镁在脊柱手术中的疗效和安全性。这项荟萃分析遵循PRISMA指南。纳入接受脊柱手术的患者，干预组接受不同剂量或组合的静脉注射硫酸镁（MS），而对照组接受其他替代方案或安慰剂。评估疗效和安全性结果。从多个数据库收集数据并使用Review Manager 5.4版进行分析。评估异质性并应用固定效应或随机效应模型。该荟萃分析纳入了八项研究（n = 541）。与安慰剂相比，硫酸镁在24小时时疼痛（MD -0.20，95%CI：-0.39至-0.02）和阿片类药物消耗量（SMD -0.66，95%CI：-0.95至-0.38）方面有显著降低。此外，观察到肌肉松弛剂的使用（SMD -0.91，95%CI：-1.65至-0.17）和瑞芬太尼（SMD -1.52，95%CI：-1.98至-1.05）有所减少。相比之下，与右美托咪定相比，观察到拔管时间延长（MD 2.42，95%CI：1.14至3.71）和语言反应（MD 1.85，95%CI：1.13至2.58）增加。总之，脊柱手术中给予硫酸镁可减轻疼痛和减少阿片类药物消耗，并延长定向力和语言反应时间。两组之间在血压或心率方面未观察到显著差异。
