硫酸镁对全麻术后疼痛和并发症影响的Meta分析.pdfVIP

Review Articles Chin J Evid-based Med 2012, 12(3): 334-340 硫酸镁对全麻术后疼痛和并发症影响的Meta分析 尹秀茹  裴  凌* 中国医科大学附属第一医院麻醉科（沈阳 110001） 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。 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 Effects of Magnesium Sulfate on Postoperative Pain and Complications after General Anesthesia: A Meta-Analysis YIN Xiu-ru, PEI Ling* Department of Anesthesiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China Abstract 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 The Cochrane Library, EMbase, 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