Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis

Kuriyama, Akira; Maeda, Hirokazu; Sun, Renhua

doi:10.1007/s12630-019-01396-7

Cited by 27 publications

(28 citation statements)

References 47 publications

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“…Although several meta-analyses in the past few years have shown that ketamine[ 31 ], lidocaine[ 14 , 32 ], corticosteroids[ 33 – 35 ], magnesium[ 36 , 37 ], benzydamine hydrochloride[ 38 ], etc. could prevent POST, there has been no comprehensive comparison between active drugs.…”

Section: Discussionmentioning

confidence: 99%

Nebulized pharmacological agents for preventing postoperative sore throat: A systematic review and network meta-analysis

Ren

Min

et al. 2020

PLoS ONE

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Postoperative sore throat is one of the most common complications following endotracheal intubation. Nebulization therapy, a preferable and safety method of drug delivery, has been shown to be effective in postoperative sore throat prevention in many studies. However, the relative efficacy of various nebulized agents remains unknown. In this review, we aimed to quantify and rank order the efficacy of available nebulized agents for various postoperative sore throat-related outcomes. A comprehensive literature search of PubMed, EMBASE, CENTRAL and Google Scholar was conducted to identify eligible studies from inception to 25 May 2020. Incidence of postoperative sore throat 1hour and 24hours postoperatively and severity of postoperative sore throat 24 hours postoperatively were the primary outcomes. We conducted a Bayesian network meta-analysis to combine direct and indirect evidence to estimate the relative effects between treatments as well as the probabilities of ranking for treatments based on their protective effects. We identified 32 trials assessing 6 interventions. Overall inconsistency and heterogeneity were acceptable. Nebulized corticosteroids, magnesium, and ketamine differed from non-analgesic methods on the three primary outcomes. Based on the surface under the cumulative ranking curve, nebulized corticosteroids ranked first in almost all outcomes among the nebulized drugs. Considering only high-quality and 2-arm design studies, nebulized corticosteroids still seemed best. In conclusion, prophylactic use of nebulized corticosteroids, magnesium, and ketamine can effectively prevent postoperative sore throat, and nebulized corticosteroids appears to be the overall best approach.

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Section: Discussionmentioning

confidence: 99%

Nebulized pharmacological agents for preventing postoperative sore throat: A systematic review and network meta-analysis

Ren

Min

et al. 2020

PLoS ONE

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“…We compared ketamine with numerous comparators that have been proven to prevent postoperative sore throat, [15][16][17][18][19][20][21] including topical lidocaine and corticosteroids as well as intravenous dexamethasone. However, comparisons of these treatments were performed in a limited number of small-sized studies, and the non-superiority Ketamine administration is associated with unwanted outcomes such as psychomimetic effects and blood pressure rise.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheal trauma, erosion, and inflammation due to endotracheal intubation are the proposed etiologies of airway morbidities that develop following extubation or postoperatively . To date, anti‐inflammatory agents such as topical corticosteroids and non‐steroidal anti‐inflammatory drug as well as intravenous corticosteroids have been proven effective in preventing such airway morbidities …”

Section: Introductionmentioning

confidence: 99%

Topical application of ketamine to prevent postoperative sore throat in adults: A systematic review and meta‐analysis

Kuriyama

Nakanishi

Kamei

et al. 2020

Acta Anaesthesiol Scand

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Background Postoperative sore throat is a leading undesirable postoperative outcome. Ketamine is an N‐methyl‐d‐aspartate receptor antagonist and its topical application is used for chronic pain and oral/throat indications. We conducted a systematic review to assess the efficacy of preoperative, topical ketamine application for preventing postoperative sore throat. Methods We searched MEDLINE, EMBASE, and CENTRAL through September 23, 2019 for randomized controlled trials in which at least one intervention was topical ketamine to prevent postoperative sore throat in adults undergoing endotracheal intubation. The primary outcome was the incidence of sore throat at 24 hours postoperatively. The comparators were non‐analgesic controls (placebo, no treatment, or usual care) or active agents. We pooled the data using a random‐effects model. Results We included 41 randomized controlled trials involving 3784 participants. Topical ketamine was associated with reduced incidence of sore throat at 24 hours postoperatively compared to non‐analgesic methods (risk ratio, 0.45; 95% CI, 0.37‐0.54; P < .001). We found significant publication bias, but the results remained unchanged with a trim‐and‐fill analysis. Trial sequential analysis (TSA) suggested that the efficacy of topical ketamine was adequate (TSA‐adjusted 95% CI, 0.33‐0.56). The GRADE quality for this evidence was moderate. Topical ketamine was inferior to a combination of nebulized ketamine and clonidine in preventing postoperative sore throat. Conclusions Preoperative, topical ketamine application may be more effective than non‐analgesic methods in preventing postoperative sore throat. The number of studies did not suffice to determine the place of topical ketamine among agents to prevent postoperative sore throat.

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“…Ostali oblici lokalne primene U značajnom broju studija magnezijum-sulfat primenjivan je u okviru intravenske regionalne anestezije (66), infiltracione anestezije (95,97) ili topikalno (97,98). Međutim, nisu sva ispitivanja pokazala postoperativnu analgetičku efikasnost lokalno primenjenog magnezijuma (26).…”

Section: Lokalna Primena Magnezijum-sulfata Kod Ljudiunclassified

Role of magnesium sulfate in the treatment of acute postoperative pain

Vučković¹,

Savić-Vujović²,

Srebro³

et al. 2019

Arhiv za farmaciju

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Ko-analgetici se često kombinuju sa opioidima kako bi se smanjila prevalenca neželjenih dejstava opioida uz isti ili čak poboljšan kvalitet analgezije. Magnezijum je esencijalni mineral koji moduliše nocicepciju dejstvom na N-metil-D-aspartatne receptore, kalcijumske, kalijumske, natrijumske i kanale za prolazne receptorske potencijale, sintazu azotnog oksida (NO) i ima druge mehanizme dejstva. Postoje dokazi da magnezijum pojačava efekte opioida, opštih i lokalnih anestetika. Kod ljudi, perioperativno intravenski primenjen magnezijum-sulfat (MS) pokazao se efikasnim u smanjenju postoperativnog bola i postoperativne potrošnje analgetika. Primenjen kao dodatak lokalnim anesteticima u neuraksijalnoj anesteziji može biti još efikasniji nego nakon sistemske primene. Takođe, u kombinaciji sa lokalnim anesteticima, može da produži nervni blok, regionalnu intravensku i infiltracionu anesteziju. MS kad se primeni lokalno, kao monoterapija, značajno smanjuje postoperativnu gušobolju. Međutim, nisu sve studije pokazale postoperativnu analgetičku efikasnost sistemski ili lokalno primenjenog MS. Primenu MS-a prati malo neželjenih efekata. Međutim, rizik od neuroloških komplikacija kod neuraksijalne primene MS još uvek nije detaljno istražen. Za sada, mali broj ispitanika i heterogenost metodologije u ispitivanjima (različite doze, način i dužina primene, različiti parametri efikasnosti) ograničavaju mogućnost donošenja konačnih zaključaka o ulozi perioperativne primene MS u lečenju postoperativnog bola.

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Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis

Cited by 27 publications

References 47 publications

Nebulized pharmacological agents for preventing postoperative sore throat: A systematic review and network meta-analysis

Nebulized pharmacological agents for preventing postoperative sore throat: A systematic review and network meta-analysis

Topical application of ketamine to prevent postoperative sore throat in adults: A systematic review and meta‐analysis

Role of magnesium sulfate in the treatment of acute postoperative pain

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