Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee surgery under general anesthesia: Randomized controlled trial

Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis

“…Two evaluators screened the titles/abstracts and full-texts of all eligible articles. Eventually, 8 RCTs232425262728 (513 patients) and 8 experimental studies13142930353637383940 (6 in vitro and 2 in vivo studies) were qualified for final analysis (Fig. 1).…”

“…The characteristics and results of the included in vitro and in vivo experimental studies are listed in Table 2. According to the Cochrane risk of bias table (Appendix 2), three trials252729 did not describe their random sequence generation (high risk of selection bias); six trials242526282930 did not design a clear allocation concealment plan (unclear or high risk of selection bias); all trials adopted the double-blind method except one27 which did not describe the blinding method of participants (high risk of performance bias); one study30 was rated as unclear risk for both incomplete data and selective reporting; six studies232425262728 did not present a competing interest statement (unclear risk of other bias). In addition, three trials252730 were rated as low methodological quality for having three or more unclear or high risk of bias.…”

“…Five trials2324272930 were eligible for assessing the postoperative pain score of IA Mg versus placebo after arthroscopic surgery at the last follow-up time point (24 or 48 hours). The combined results showed a significantly lower pain score of Mg (MD, −0.41, 95% CI, −0.78 to −0.05, p = 0.03).…”

“…More importantly, Mg has been proved to be able to enhance the chondrocyte viability either alone or in combination with a local anesthetic (rather than a local anesthetic alone), and it was therefore proposed to be a potential alternative IA analgesic agent due to its effect on chondrotoxicity reduction1314. However, it remains to be a controversial issue whether the single-dose IA Mg after arthroscopic surgery is effective in pain relief when compared with placebo, or whether the IA Mg exhibits a comparable effect when compared with bupivacaine, which is the most widely used local analgesic at present2324252627282930. In addition, there is also a great significance for clinical practice to explore whether IA Mg can amplify the analgesic effect of bupivacaine and reduce the chondrotoxicity of local anesthetics.…”

Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

“…A recent study revealed magnesium had antinociceptive effects in animal and human models of chronic pain (6). It was shown to be effective as a postoperative analgesic in orthopedic surgery (7,8). The analgesic property of magnesium is associated with inhibition of the N-methyl-D-aspartate (NMDA) receptor and modulation of calcium channels (9).…”