Wang Qiuyuan, Li Feng, Yang Yidan, Yue Chen, Guo Jiayi
Department of Evidence-based Medicine, Luoyang Orthopedic Hospital of Henan Province. Orthopedic Hospital of Henan Province, Luoyang, China.
Department of Bone And Joint Diseases, Luoyang Orthopedic Hospital of Henan Province. Orthopedic Hospital of Henan Province, Luoyang, China.
EFORT Open Rev. 2024 Sep 2;9(9):896-907. doi: 10.1530/EOR-23-0185.
Although magnesium sulfate (MgSO4) is widely used as an analgesic adjuvant to peripheral analgesic cocktails, its efficacy in total knee arthroplasty (TKA) is still controversial. Therefore, we systematically reviewed and meta-analyzed the literature to assess the analgesic efficacy of MgSO4 as an adjuvant to the analgesic cocktail in TKA.
The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched. The meta-analysis was performed according to the PRISMA guidelines. Data were qualitatively synthesized or meta-analyzed using a random-effects model.
Five randomized controlled trials involving 432 patients were included. Meta-analyses detected significant differences between the MgSO4 and control groups in the visual analog scale (VAS) pain scores (rest) at 6, 12, and 24 h postoperatively; VAS pain scores (motion) at 12, 24, and 48 h postoperatively; morphine consumption within 24 h, 24-48 h, and during the total hospitalization period; time to first rescue analgesia after TKA; and length of hospital stay. Regarding the functional recovery, the meta-analysis demonstrated significant differences between groups in terms of knee range of motion on postoperative day 1; daily mobilization distance on postoperative day 1; and daily mobilization distance. There was no significant intergroup difference in surgical complications.
The findings suggest that MgSO4 is a promising adjunct to the analgesic cocktail, achieving significant improvements in pain scores and total opioid consumption during the early postoperative period after TKA.
尽管硫酸镁（MgSO4）作为外周镇痛合剂的镇痛辅助药物被广泛使用，但其在全膝关节置换术（TKA）中的疗效仍存在争议。因此，我们系统回顾并荟萃分析了相关文献，以评估MgSO4作为TKA镇痛合剂辅助药物的镇痛效果。
检索了PubMed、EMBASE、科学网和Cochrane图书馆数据库。根据PRISMA指南进行荟萃分析。使用随机效应模型对数据进行定性合成或荟萃分析。
纳入了5项涉及432例患者的随机对照试验。荟萃分析发现，MgSO4组与对照组在术后6、12和24小时的视觉模拟量表（VAS）疼痛评分（静息时）；术后12、24和48小时的VAS疼痛评分（活动时）；24小时内、24 - 48小时内及整个住院期间的吗啡消耗量；TKA后首次补救镇痛的时间；以及住院时间方面存在显著差异。关于功能恢复，荟萃分析表明，两组在术后第1天的膝关节活动范围、术后第1天的每日活动距离以及每日活动距离方面存在显著差异。手术并发症方面组间无显著差异。
研究结果表明，MgSO4是镇痛合剂的一种有前景的辅助药物，在TKA术后早期可显著改善疼痛评分和总阿片类药物消耗量。
