静脉内镁治疗慢性疼痛：文献更新综述。

Intravenous Magnesium for the Management of Chronic Pain:An Updated Review of the Literature.

机构信息

Onyeaka, MBCHB, MPH, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Mclean Hospital, Belmont, MA, USA.

Adeola, MD, MS, Department of Anesthesiology and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Psychopharmacol Bull. 2024 Aug 19;54(4):81-105.

PMID:39263198

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11385265/

Abstract

BACKGROUND

Available therapeutic options are currently limited by their modest efficacy. As a result, novel pharmacotherapeutic treatments with different mechanisms have recently attracted empirical attention. Magnesium, a divalent cation, is postulated to provide analgesic and anti-nociceptive effect through its action at the N-methyl-D-aspartate (NMDA) receptor.

OBJECTIVE

Considering the evidence surrounding magnesium's potential as a therapeutic modality for chronic pain, we conducted a narrative review on the evidence of magnesium's therapeutic effects in chronic pain.

METHODS

A review of the PubMed, and Google scholar databases was undertaken in May 2022 to identify completed studies that investigated the effectiveness of magnesium in the treatment of chronic pain from database inception to May 2022.

RESULTS

A total of 33 studies were included in the narrative review, out of which 26 were randomized controlled trials. Findings on available studies suggest that intravenous infusion of magnesium is an emerging and promising option that may alleviate pain in some clinical populations. Our narrative synthesis showed that evidence for intravenous magnesium is currently equivocal for a variety of chronic pain syndrome. Findings indicate that evidence for efficacy is poor or equivocal for: CRPS, neuropathic pain, chronic low back pain, and migraine prophylaxis. However, there is good evidence supporting the efficacy of intravenous magnesium for treating renal colic pain and pelvic pain related to endometriosis.

CONCLUSION

Magnesium may be a promising pharmacologic solution for chronic pain. Future investigation is warranted on elucidating the neurobiological mechanisms of magnesium in attenuating pain signaling pathways.

摘要

背景

目前可用的治疗选择受到疗效有限的限制。因此，最近具有不同作用机制的新型药物治疗方法引起了人们的关注。镁是一种二价阳离子，据推测，它通过作用于 N-甲基-D-天冬氨酸（NMDA）受体，发挥镇痛和抗伤害作用。

目的

鉴于镁作为慢性疼痛治疗方法的潜力，我们对镁在慢性疼痛治疗中的疗效证据进行了叙述性综述。

方法

2022 年 5 月，我们对 PubMed 和 Google Scholar 数据库进行了检索，以确定从数据库建立到 2022 年 5 月期间，研究镁治疗慢性疼痛疗效的已完成研究。

结果

共有 33 项研究纳入叙述性综述，其中 26 项为随机对照试验。现有研究的结果表明，静脉输注镁是一种新兴且有前途的选择，可能会减轻某些临床人群的疼痛。我们的叙述性综合分析表明，静脉注射镁的证据目前在各种慢性疼痛综合征中尚不确定。结果表明，镁治疗复杂性区域疼痛综合征、神经病理性疼痛、慢性腰痛和偏头痛预防性治疗的疗效证据较差或不确定。然而，有充分证据支持静脉注射镁治疗肾绞痛和与子宫内膜异位症相关的盆腔疼痛。