Abstract：Objective To evaluate the effect of Magnesium Sulfate to prevent shivering during cesarean section. Methods Databases including PubMed, The Cochrane Library (Issue 8, 2019), EMbase, Wanfang Data Knowledge Service Platform (WanFang Data), China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM) were searched for computer to collect the randomized controlled trails (RCT) about the effect of Magnesium Sulfate on shivering for cesarean section. The retrieval time limit from repository to August 2019. The literature was tracked based on the references included in the RCT. Meta-analysis was conducted using RevMan 5.3 software, GRADE of evidence quality was used to evaluate the evidence level of meta-analysis results. Results Finally, 15 references were included, including 1043 patients and 532 patients with Magnesium Sulfate. The results of meta-analysis showed that: the incidence of shivering in experimental group was lower than that in control group (RR = 0.48, 95%CI：0.37-0.63, P ＜ 0.000 01). The incidence of shivering in intravenous subgroup was lower than that in control group (RR = 0.46, 95%CI：0.33-0.66, P ＜ 0.0001); the incidence of shivering in subarachnoid injection subgroup had no statistically significant difference compared with control group (P = 0.12); the incidence of shivering in epidural injection subgroup was lower than that in control group (RR = 0.38, 95%CI：0.21-0.67, P = 0.0009). The incidence of shivering in subarachnoid anesthesia subgroup was lower than that in control group (RR = 0.53, 95%CI: 0.36-0.78, P = 0.001); the incidence of shivering in combined lumbar and epidural anesthesia subgroup was lower than that in control group (RR = 0.45, 95%CI: 0.29-0.68, P = 0.0002). Meta-analysis results for different administration subgroups were all evaluated as “Moderate”. Conclusion Intravenous injection and epidural injection of Magnesium Sulfate can prevent shivering in cesarean section, but the effect of subarachnoid injection of Magnesium Sulfate to prevent the occurrence of shivering in cesarean section remains to be evaluated.
尚勇 李帆 胡振飞 邹田田. 硫酸镁预防剖宫产术产妇寒战的meta分析[J]. 中国医药导报, 2020, 17(21): 103-108.
SHANG Yong LI Fan HU Zhenfei ZOU Tiantian. Meta-analysis of Magnesium Sulfate to prevent shivering during cesarean section. 中国医药导报, 2020, 17(21): 103-108.
[1] Nasseri K，Ghadami N，Nouri B. Effects of intrathecal dexm-edetomidine on shivering after spinal anesthesia for cesarean section：a double-blind randomized clinical trial [J]. Drug Des Devel Ther，2017，11：1107-1113.
[2] Khezri MB，Mosallaei MA，Ebtehaj M，et al. Comparison of preemptive effect of intravenous ketorolac versus meperidine in patients undergoing cesarean section：A prospective，randomized，double-blind study [J]. Caspian J Intern Med，2018，9（2）：151-157.
[3] Nallam SR，Cherukuru K，Sateesh G. Efficacy of intravenous ondansetron for prevention of postspinal shivering during lower segment cesarean section：A double-blinded randomized trial [J]. Anesth Essays Res，2017，11（2）：508-513.
[4] Lopez MB. Postanaesthetic shivering–from pathophysiology to prevention [J]. Rom J Anaesth Intensive Care，2018， 25（1）：73-81.
[5] Jain A，Gray M，Slisz S，et al. Shivering Treatments for Targeted Temperature Management：A Review [J]. J Neurosci Nurs，2018，50（2）：63-67.
[6] Higgins JPT，Green S（editors）. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011. Available at：www.cochrane-handbook.org.
[7] Agrawal J，Singh K，Mittal R，et al. A randomized clinical study to evaluate the effect of intravenous magnesium sulphate for postoperative pain relief in patients undergoing lower segment caesarean section [J]. J Evolution Med Dent Sci，2015，72（4）：12478-12484.
[8] Elsharkawy RA，Farahat TE，Abdelhafez MS. Analgesic effect of adding magnesium sulfate to epidural levobupivacaine in patients with pre-eclampsia undergoing elective cesarean section [J]. J Anaesthesiol Clin Pharmacol，2018， 34（3）：328-334.
[9] Faiz SH，Rahimzadeh P，Imani F，et al. Intrathecal injection of magnesium sulfate：shivering prevention during cesarean section：a randomized，double-blinded，controlled study [J]. Korean J Anesthesiol，2013，65（4）：293-298.
[10] Maulik SG，Chaudhuri A，Mallick S，et al. Role of Magnesium Sulfate In Prolonging The Analgesic Effect of Spinal Bupivacaine For Cesarean Section In Severe Preeclamptics [J]. J Basic Clin Reprod Sci，2015，4（1）：24-28.
[11] Paleti S，Prasad PK，Lakshmi BS. A randomized clinical trial of intrathecal magnesium sulfate versus midazolam with epidural administration of 0.75% ropivacaine for patients with preeclampsia scheduled for elective cesarean section [J]. J Anaesthesiol Clin Pharmacol，2018，34（1）：23-28.
[12] Sachidananda R，Basavaraj K，Shaikh SI，et al. Comparison of Prophylactic Intravenous Magnesium Sulfate with Tramadol for Postspinal Shivering in Elective Cesarean Section：A Placebo Controlled Randomized Double-blind Pilot Study [J]. Anesth Essays Res，2018，12（1）：130-134.
[13] Sayed JA，Fathy MA. Maternal and Neonatal Effects of Adding Two Different Doses of Intrathecal Magnesium Sulphate to Bupivacain Fentanyl Spinal Anesthesia in Mild Preeclamptic Patients Undergoing Caesarean Section [J]. J Am Sci，2012，8（6）：435-441.
[14] Sun J，Wu X，Xu X，et al. A Comparison of Epidural Magnesium and/or Morphine With Bupivacaine for Postoperative Analgesia After Cesarean Section [J]. Int J Obstet Anesth，2012，21（4）：310-316.
[15] Unlugenc H，Ozalevli M，Gunes M，et al. Comparison of intrathecal magnesium，fentanyl，or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery [J]. Acta Anaesthesiol Scand，2009， 53（3）：346-353.
[16] Xiao F，Liu L，Zhang WP，et al. Effect of adding magnesium sulfate to intrathecal low-dose of bupivacaine for patients with severe pre-eclampsia undergoing cesarean delivery [J]. Int J Clin Exp Med，2016，9（10）：19749-19756.
[17] Xiao F，Xu W，Feng Y，et al. Intrathecal magnesium sulfate does not reduce the ED50 of intrathecal hyperbaric bupivacaine for cesarean delivery in healthy parturients：a prospective，double blinded，randomized dose-response trial using the sequential allocation method [J]. BMC Anesthesiol，2017，17（1）：8.
[18] Yousef AA，Amr YM. The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia：a prospective double blind randomised study [J]. Int J Obstet Anesth，2010，19（4）：401-404.
[19] Zhong HY，Zhang WP. Effect of intravenous magnesium sulfate on bupivacaine spinal anesthesia in preeclamptic patients [J]. Biomed Pharmacother，2018，108：1289-1293.
[20] 王奎，朱宇麟.硫酸镁对剖宫产产妇行舒芬太尼复合布比卡因腰硬联合麻醉的效果及术后镇痛的影响[J].医学临床研究，2018，35（10）：1984-1986.
[21] 王新妃.小剂量硫酸镁预防剖宫产术中寒战发生的临床观察[J].中国药师，2012，15（10）：1467-1468.
[22] 张红，冯艺，潘芳，等.全身麻醉术后寒战相关危险因素的研究[J].临床麻醉学杂志，2010，26（3）：203-205.
[23] Wu LX，Huang X，Sun L. The efficacy of N-methyl-d-aspartate receptor antagonists on improving the postoperative pain intensity and satisfaction after remifentanil-based anesthesia in adults：a meta-analysis [J]. J Clin Anesth，2015，27（4）：311-324.
[24] Martin-Flores M. Epidural and Spinal Anesthesia [J]. Vet Clin North Am Small Anim Pract，2019，49（6）：1095-1108.
2020, Vol. 17 
京公网安备 11010502046598号