硫酸镁对全麻术后疼痛和并发症影响的Meta分析  

Effects of Magnesium Sulfate on Postoperative Pain and Complications after General Anesthesia:A Meta-Analysis

作　　者：尹秀茹[1] 裴凌[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳110001

出　　处：《中国循证医学杂志》2012年第3期334-340,共7页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价硫酸镁对全麻术后疼痛和并发症的影响。方法计算机检索Cochrane图书馆、EMbase、PubMed、EBSCO、Springer、Ovid、CNKI、CBM等数据库,收集从建库至2011年9月间关于全身麻醉中静脉应用硫酸镁的随机对照试验(RCT),按Cochrane系统评价方法对纳入文献进行资料提取和质量评价后,采用RevMan 5.1软件进行统计分析。结果共纳入11个RCT,包括905例患者。Meta分析结果显示:与对照组相比,全身麻醉中静脉应用硫酸镁能显著降低患者术后2、4、6、8、16及24小时各时点的疼痛视觉模拟(VAS)评分,减少术后24小时的吗啡用量,降低术后恶心呕吐[RR=0.61,95%CI(0.40,0.91),P=0.02]及寒战[RR=0.29,95%CI(0.14,0.59),P=0.000 7]的发生率;心动过缓的发生率[RR=1.93,95%CI(1.05,3.53),P=0.03]虽有所增加,但未造成不良后果,且两组在低血压发生率和血镁浓度变化方面的差异无统计学意义。结论全身麻醉中静脉应用硫酸镁能明显降低患者术后疼痛程度,降低术后恶心呕吐及寒战的发生率,且不增加心血管不良事件和高镁血症的风险。但上述结果尚需更多高质量、大样本的随机对照试验进一步验证。Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and com- plications after general anesthesia. Methods A literature search was conducted in following databases as 3-he Cochrane Library, EMhase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials （RCTs） about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of mag- nesium sulfate during general anesthesia significantly reduced the visual analog scale （VAS） scores at the time-points of 2, 4, 6, 8, 16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting （RR=0.61, 95%CI 0.40 to 0.91, P=0.02） and chilling （RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7）. Although the incidents ofbradycardia （RR=l.93, 95%CI 1.05 to 3.53, P=0.03） increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclu- sion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.

关 键 词：硫酸镁 疼痛 全身麻醉 META分析 系统评价 随机对照试验 

分 类 号：R614[医药卫生—麻醉学]