Meta-analysis of the efficacy of ketamine in postoperative pain control in adolescent idiopathic scoliosis patients undergoing spinal fusion

Mariscal, Gonzalo; Morales, Jorge; Pérez, Silvia; Rubio-Belmar, Pedro Antonio; Bovea-Marco, Miquel; Bas, José Luis; Bas, Paloma; Bas, Teresa

doi:10.1007/s00586-022-07422-5

Cited by 4 publications

(1 citation statement)

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“…Encouragingly, these investigations have demonstrated a significant reduction in opioid consumption within the first 48 h post-surgery, accompanied by a decrease in pain intensity. Moreover, the use of ketamine and gabapentin has shown a favorable safety profile with minimal occurrence of adverse events [ 6 , 7 ]. However, optimizing pain management remains crucial because a delay in mobilization can lead to significant adverse events [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Intravenous Magnesium Sulfate in Spinal Surgery: A Systematic Review and Meta-Analysis

Campos,

Bas,

Campos

et al. 2024

JCM

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Optimizing pain management in spinal surgery is crucial for preventing adverse events due to delayed mobilization. Magnesium sulfate has potential benefits in spinal surgery because of its analgesic properties and modulation of neurotransmitters and autonomic nervous system. Existing evidence regarding the use of magnesium sulfate is partial and controversial, necessitating a comprehensive meta-analysis to evaluate its efficacy and safety. The aim of this study was to conduct a comprehensive meta-analysis to evaluate the efficacy and safety of magnesium sulfate in spinal surgery compared to other available options. This meta-analysis adhered to the PRISMA guidelines. Patients undergoing spinal surgery were included, with the intervention group receiving intravenous magnesium sulfate (MS) at various doses or combinations, whereas the comparison group received other alternatives or a placebo. The efficacy and safety outcomes were assessed. Data were collected from multiple databases and analyzed using Review Manager version 5.4. Heterogeneity was assessed and fixed- or random-effects models were applied. The meta-analysis included eight studies (n = 541). Magnesium sulfate demonstrated significant reductions in pain at 24 h (MD −0.20, 95% CI: −0.39 to −0.02) and opioid consumption (SMD −0.66, 95% CI: −0.95 to −0.38) compared to placebo. Additionally, a decrease in the use of muscle relaxants (SMD −0.91, 95% CI: −1.65 to −0.17) and remifentanil (SMD −1.52, 95% CI: −1.98 to −1.05) was observed. In contrast, an increase in extubation time (MD 2.42, 95% CI: 1.14 to 3.71) and verbal response (MD 1.85, 95% CI: 1.13 to 2.58) was observed compared to dexmedetomidine. In conclusion, magnesium sulfate administration in spinal surgery reduced pain and opioid consumption, and prolonged orientation and verbal response. No significant differences in blood pressure or heart rate were observed between the groups.

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Section: Introductionmentioning

confidence: 99%