Neuraxial magnesium sulfate improves postoperative analgesia in Cesarean section delivery women: A meta-analysis of randomized controlled trials

Shih Ching Wang, Po Ting Pan, Hsiao Yean Chiu, Chun Jen Huang

Research output: Contribution to journalArticle

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Abstract

Background We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. Method We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens. The primary outcomes included analgesic duration of neuraxial anesthesia, postoperative pain scores and postoperative consumption of analgesics. The secondary outcomes included patients’ satisfaction and adverse effects related to postoperative analgesia. Results Nine relevant studies comprising a total of 827 women undergoing CS delivery were included. Analyses revealed that CS women receiving additional neuraxial MgSO4 (the MgSO4 group) had longer duration of neuraxial anesthesia (effect size [ES] = 1.920, 95% confidence interval [CI] = 0.999 to 2.842, P < 0.001), longer duration of sensory block (ES = 1.020, 95% CI = 0.463 to 1.577, P < 0.001), lower postoperative pain scores at rest (ES = −1.206, 95% CI = −2.084 to −0.329, P = 0.007), pain scores with motion (ES = −1.435, 95% CI = −2.631 to −0.240, P = 0.019) and consumption of analgesics (ES = −1.620, 95% CI = −2.434 to −0.806, P < 0.001) than CS women without receiving additional neuraxial MgSO4 (the control group). Of note, the MgSO4 group tended to have higher rate on rating satisfaction as “excellent” than the control group did (odds ratio = 3.748, 95% CI = 2.218 to 6.332, P < 0.001). However, the incidences of adverse effects (i.e., nausea and vomiting, pruritus and hypotension) were not significantly different between these two groups. Conclusion Neuraxial MgSO4 improves postoperative analgesia in CS women.

Original languageEnglish
Pages (from-to)56-67
Number of pages12
JournalAsian Journal of Anesthesiology
Volume55
Issue number3
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Magnesium Sulfate
Cesarean Section
Analgesia
Meta-Analysis
Randomized Controlled Trials
Confidence Intervals
Analgesics
Anesthesia
Postoperative Pain
Control Groups
Pruritus
Patient Satisfaction
PubMed
Hypotension
Nausea
Vomiting
Odds Ratio
Pain
Incidence

Keywords

  • Cesarean section
  • Magnesium sulfate
  • Postoperative analgesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Neuraxial magnesium sulfate improves postoperative analgesia in Cesarean section delivery women : A meta-analysis of randomized controlled trials. / Wang, Shih Ching; Pan, Po Ting; Chiu, Hsiao Yean; Huang, Chun Jen.

In: Asian Journal of Anesthesiology, Vol. 55, No. 3, 01.09.2017, p. 56-67.

Research output: Contribution to journalArticle

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abstract = "Background We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. Method We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens. The primary outcomes included analgesic duration of neuraxial anesthesia, postoperative pain scores and postoperative consumption of analgesics. The secondary outcomes included patients’ satisfaction and adverse effects related to postoperative analgesia. Results Nine relevant studies comprising a total of 827 women undergoing CS delivery were included. Analyses revealed that CS women receiving additional neuraxial MgSO4 (the MgSO4 group) had longer duration of neuraxial anesthesia (effect size [ES] = 1.920, 95{\%} confidence interval [CI] = 0.999 to 2.842, P < 0.001), longer duration of sensory block (ES = 1.020, 95{\%} CI = 0.463 to 1.577, P < 0.001), lower postoperative pain scores at rest (ES = −1.206, 95{\%} CI = −2.084 to −0.329, P = 0.007), pain scores with motion (ES = −1.435, 95{\%} CI = −2.631 to −0.240, P = 0.019) and consumption of analgesics (ES = −1.620, 95{\%} CI = −2.434 to −0.806, P < 0.001) than CS women without receiving additional neuraxial MgSO4 (the control group). Of note, the MgSO4 group tended to have higher rate on rating satisfaction as “excellent” than the control group did (odds ratio = 3.748, 95{\%} CI = 2.218 to 6.332, P < 0.001). However, the incidences of adverse effects (i.e., nausea and vomiting, pruritus and hypotension) were not significantly different between these two groups. Conclusion Neuraxial MgSO4 improves postoperative analgesia in CS women.",
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AU - Huang, Chun Jen

PY - 2017/9/1

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N2 - Background We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. Method We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens. The primary outcomes included analgesic duration of neuraxial anesthesia, postoperative pain scores and postoperative consumption of analgesics. The secondary outcomes included patients’ satisfaction and adverse effects related to postoperative analgesia. Results Nine relevant studies comprising a total of 827 women undergoing CS delivery were included. Analyses revealed that CS women receiving additional neuraxial MgSO4 (the MgSO4 group) had longer duration of neuraxial anesthesia (effect size [ES] = 1.920, 95% confidence interval [CI] = 0.999 to 2.842, P < 0.001), longer duration of sensory block (ES = 1.020, 95% CI = 0.463 to 1.577, P < 0.001), lower postoperative pain scores at rest (ES = −1.206, 95% CI = −2.084 to −0.329, P = 0.007), pain scores with motion (ES = −1.435, 95% CI = −2.631 to −0.240, P = 0.019) and consumption of analgesics (ES = −1.620, 95% CI = −2.434 to −0.806, P < 0.001) than CS women without receiving additional neuraxial MgSO4 (the control group). Of note, the MgSO4 group tended to have higher rate on rating satisfaction as “excellent” than the control group did (odds ratio = 3.748, 95% CI = 2.218 to 6.332, P < 0.001). However, the incidences of adverse effects (i.e., nausea and vomiting, pruritus and hypotension) were not significantly different between these two groups. Conclusion Neuraxial MgSO4 improves postoperative analgesia in CS women.

AB - Background We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. Method We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens. The primary outcomes included analgesic duration of neuraxial anesthesia, postoperative pain scores and postoperative consumption of analgesics. The secondary outcomes included patients’ satisfaction and adverse effects related to postoperative analgesia. Results Nine relevant studies comprising a total of 827 women undergoing CS delivery were included. Analyses revealed that CS women receiving additional neuraxial MgSO4 (the MgSO4 group) had longer duration of neuraxial anesthesia (effect size [ES] = 1.920, 95% confidence interval [CI] = 0.999 to 2.842, P < 0.001), longer duration of sensory block (ES = 1.020, 95% CI = 0.463 to 1.577, P < 0.001), lower postoperative pain scores at rest (ES = −1.206, 95% CI = −2.084 to −0.329, P = 0.007), pain scores with motion (ES = −1.435, 95% CI = −2.631 to −0.240, P = 0.019) and consumption of analgesics (ES = −1.620, 95% CI = −2.434 to −0.806, P < 0.001) than CS women without receiving additional neuraxial MgSO4 (the control group). Of note, the MgSO4 group tended to have higher rate on rating satisfaction as “excellent” than the control group did (odds ratio = 3.748, 95% CI = 2.218 to 6.332, P < 0.001). However, the incidences of adverse effects (i.e., nausea and vomiting, pruritus and hypotension) were not significantly different between these two groups. Conclusion Neuraxial MgSO4 improves postoperative analgesia in CS women.

KW - Cesarean section

KW - Magnesium sulfate

KW - Postoperative analgesia

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