Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis.
Study Goal
To examine the analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery.
Results Summary
Intra-articular magnesium significantly reduced pain scores compared to placebo and enhanced the analgesic effect of bupivacaine without increasing adverse reactions. Experimental studies also suggested a chondrocyte protective effect of magnesium.
Population
Patients undergoing arthroscopic surgery.
Effective Dosage
Single-dose intra-articular (specific dosage not mentioned).
Duration
Single administration.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
single-dose intra-articular (IA) magnesium (Mg) | decrease | pain score | patients after arthroscopic surgery | MD, -0.41, 95% CI, -0.78 to -0.05, p = 0.03 | exhibited a significantly lower pain score | #1 |
Mg | no change | pain relief | patients after arthroscopic surgery | no significant difference | no significant difference | #2 |
Mg | no change | time to first analgesic request | patients after arthroscopic surgery | no significant difference | no significant difference | #3 |
Mg plus bupivacaine | decrease | pain score | patients after arthroscopic surgery | MD, -0.62, 95% CI, -0.81 to -0.42, p < 0.00001 | statistically significant differences in pain score | #4 |
Mg plus bupivacaine | increase | time to first analgesic request | patients after arthroscopic surgery | MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001 | statistically significant differences in time to first analgesic request | #5 |
single-dose IA Mg | no change | adverse reactions | patients after arthroscopic surgery | no statistically significant difference | no statistically significant difference | #6 |
Mg supplementation | increase | chondrocyte protection | in vitro cell cultures | - | chondrocyte protective effect | #7 |
IA Mg | increase | cartilage protection | in vivo models | - | cartilage protective effect | #8 |
To examine the analgesic effect and safety of single-dose intra-articular (IA) magnesium (Mg) after arthroscopic surgery. Pubmed, Embase and Cochrane library were searched through in January 2016. Eight RCTs and eight experimental studies were included. The IA Mg exhibited a significantly lower pain score when compared with placebo (MD, -0.41, 95% CI, -0.78 to -0.05, p = 0.03). There was no significant difference between Mg and bupivacaine in terms of pain relief and the time to first analgesic request. Furthermore, statistically significant differences both in pain score (MD, -0.62, 95% CI, -0.81 to -0.42, p < 0.00001) and time to first analgesic request (MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001) were observed between Mg plus bupivacaine and bupivacaine alone. There was no statistically significant difference among the various groups with respect to adverse reactions. Most of the included in vitro studies reported the chondrocyte protective effect of Mg supplementation. There were also two in vivo studies showing the cartilage protective effect of IA Mg. The single-dose IA Mg following arthroscopic surgery was effective in pain relief without increasing adverse reactions, and it could also enhance the analgesic effect of bupivacaine. In addition, Mg seemed to possess the cartilage or chondrocyte protective effect based on experimental studies.