Jin Zhaoguo, Zhao Jianyong
First People's Hospital of Linping District, Hangzhou, China.
Front Pharmacol. 2025 Jun 18;16:1624119. doi: 10.3389/fphar.2025.1624119. eCollection 2025.
Effective pain management following spinal surgery is crucial for preventing complications related to delayed mobilization. Magnesium sulfate (MgSO) has shown promise as an analgesic agent, influencing neurotransmitter modulation and autonomic nervous system regulation. However, studies evaluating its effectiveness and safety in spinal surgery remain inconsistent, necessitating a comprehensive meta-analysis to assess its role.
This study aimed to perform a systematic meta-analysis to compare the safety and efficacy of magnesium sulfate against standard therapeutic options in spinal surgery.
The meta-analysis followed PRISMA guidelines. We performed data extraction and analysis using Review Manager version 5.4. The study population included patients undergoing spinal surgery, with the intervention group receiving intravenous magnesium sulfate at varying dosages or in combination with other agents. The comparison group received either a placebo or alternative treatments. Primary outcomes included pain intensity, opioid consumption, and safety parameters.
Ten randomized controlled trials involving 641 patients were included. Magnesium sulfate administration significantly reduced pain scores at 24 h (MD -0.18, 95% CI: -0.34 to -0.02) and decreased opioid consumption (SMD -0.34, 95% CI: -1.07 to -0.35). Additionally, a significant reduction in muscle relaxant usage was observed (SMD -0.91, 95% CI: -0.66 to -0.10). When compared with dexmedetomidine, magnesium sulfate improved verbal response (MD 1.22, 95% CI: -0.16-2.61) and prolonged extubation time (MD 0.91, 95% CI: -0.98-2.80). No significant differences in hemodynamic parameters (heart rate and blood pressure) were observed between the groups.
Intravenous magnesium sulfate demonstrated significant benefits in reducing postoperative pain and opioid consumption, while also improving verbal response and orientation. These findings suggest that magnesium sulfate may serve as a valuable adjunct in the perioperative management of spinal surgery patients. Further research is required to confirm these results and establish optimal dosing protocols.
脊柱手术后有效的疼痛管理对于预防与延迟活动相关的并发症至关重要。硫酸镁已显示出作为一种镇痛剂的潜力，可影响神经递质调节和自主神经系统调节。然而，评估其在脊柱手术中的有效性和安全性的研究结果仍不一致，因此需要进行全面的荟萃分析来评估其作用。
本研究旨在进行系统的荟萃分析，以比较硫酸镁与脊柱手术中标准治疗方案的安全性和有效性。
荟萃分析遵循PRISMA指南。我们使用Review Manager 5.4版进行数据提取和分析。研究人群包括接受脊柱手术的患者，干预组接受不同剂量的静脉注射硫酸镁或与其他药物联合使用。对照组接受安慰剂或替代治疗。主要结局包括疼痛强度、阿片类药物消耗量和安全参数。
纳入了10项涉及641例患者的随机对照试验。静脉注射硫酸镁在24小时时显著降低了疼痛评分（MD -0.18，95% CI：-0.34至-0.02），并减少了阿片类药物的消耗量（SMD -0.34，95% CI：-1.07至-0.35）。此外，观察到肌肉松弛剂的使用显著减少（SMD -0.91，95% CI：-0.66至-0.10）。与右美托咪定相比，硫酸镁改善了言语反应（MD 1.22，95% CI：-0.16 - 2.61）并延长了拔管时间（MD 0.91，95% CI：-0.98 - 2.80）。两组之间在血流动力学参数（心率和血压）方面未观察到显著差异。
静脉注射硫酸镁在减轻术后疼痛和阿片类药物消耗量方面显示出显著益处，同时还改善了言语反应和定向力。这些发现表明硫酸镁可能是脊柱手术患者围手术期管理中有价值的辅助药物。需要进一步的研究来证实这些结果并确定最佳给药方案。
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