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Intravenous Magnesium Sulphate for Analgesia after Caesarean Section: A Systematic Review

机译:剖腹产后镇痛静脉内硫酸镁:系统审查

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摘要

Objective. To summarise the evidence for use of intravenous magnesium for analgesic effect in caesarean section patients. Background. Postcaesarean pain requires effective analgesia. Magnesium, an N-methyl-D-aspartate receptor antagonist and calcium-channel blocker, has previously been investigated for its analgesic properties. Methods. A systematic search was conducted of PubMed, Scopus, MEDLINE, Cochrane Library, and Google Scholar databases for randomised-control trials comparing intravenous magnesium to placebo with analgesic outcomes in caesarean patients. Results. Ten trials met inclusion criteria. Seven were qualitatively compared after exclusion of three for unclear bias risk. Four trials were conducted with general anaesthesia, while three utilised neuraxial anaesthesia. Five of seven trials resulted in decreased analgesic requirement postoperatively and four of seven resulted in lower serial visual analogue scale scores. Conclusions. Adjunct analgesic agents are utilised to improve analgesic outcomes and minimise opioid side effects. Preoperative intravenous magnesium may decrease total postcaesarean rescue analgesia consumption with few side effects; however, small sample size and heterogeneity of methodology in included trials restricts the ability to draw strong conclusions. Therefore, given the apparent safety and efficacy of magnesium, its role as an adjunct analgesic in caesarean section patients should be further investigated with the most current anaesthetic techniques.
机译:客观的。总结在剖腹产术患者中使用静脉内镁对镇痛作用的证据。背景。后剖腹产疼痛需要有效的镇痛。已经研究了镁,N-甲基-D-天冬氨酸受体拮抗剂和钙通道阻断剂以其镇痛性。方法。进行了系统搜索,进行了PubMed,Scopus,Medline,Cochrane图书馆和谷歌学者数据库,用于随机控制试验,将静脉内镁与剖腹产患者的镇痛结果进行安慰剂。结果。十次试验符合纳入标准。在排除三个以进行偏差风险之后,七个被定性比较。用全身麻醉进行四次试验,而三种试验是三种使用的神经麻醉。七项试验中的五种试验导致术后镇痛要求减少,七个中的四种试验导致序列视觉模拟规模分数下降。结论。辅助镇痛剂用于改善镇痛结果并最大限度地减少阿片类副作用。术前静脉内镁可降低副作用的总后救援镇痛消耗量;然而,包括试验中的方法的小样本大小和异质性限制了绘制了得出得出得出得很重要的能力。因此,鉴于镁的表观安全性和有效性,应进一步研究其作为剖腹产患者的辅助镇痛的作用,以进一步利用最新的麻醉技术。

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