Magnesium-Is There a Signal in the Noise?

摘要

THE administration of intravenous magnesium for postoperative pain has been studied for decades. Some studies have demonstrated statistically significant benefits, whereas others have concluded that there is no efficacy. A meta-analysis by De Oliveira et al. in this issue of Anesthesiology, combines the results of many small, inadequately powered studies to provide a big picture. Notably, 18 of 18 studies demonstrated a reduction in postoperative opioid requirements (see De Oliveira1 figure 10). Unless there has been significant publication bias, the odds that this would occur by chance alone is 1 in 218 {i.e., 1 in 262,144 or P ?.001). On the basis of the published data, perioperative magnesium reduces postoperative use of opioids. There is a signal in the noise! Magnesium does something. Is that something useful?