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

  • Akira KuriyamaEmail author
  • Hirokazu Maeda
  • Rao Sun
Review Article/Brief Review

Abstract

Background

Postoperative sore throat negatively affects patient satisfaction and recovery. We conducted a systematic review and meta-analysis to examine the efficacy of preoperative topical administration of magnesium sulfate in preventing postoperative sore throat in adult patients.

Methods

We searched Medline, EMBASE, China National Knowledge Infrastructure, and the Cochrane Central Register of Controlled Trials from inception to 6 October, 2018. We included randomized-controlled trials that assessed the efficacy and safety of topical application of magnesium preoperatively in adult patients who underwent endotracheal intubation for general anesthesia. We then pooled the data using a random-effects model and conducted a trial sequential analysis on the incidence of sore throat. Our primary outcome was the incidence of sore throat at 24 hr after surgery/extubation. Our secondary outcomes included the severity of sore throat at 24 hr after surgery/extubation and adverse events.

Results

Eleven randomized-controlled trials involving 1,096 patients were included in this study. Topical application of magnesium was associated with reduced incidence of postoperative sore throat (risk ratio, 0.31; 95% confidence interval [CI], 0.21 to 0.45) as well as reduced severity of postoperative sore throat (standardized mean difference, − 2.66; 95% CI, − 3.89 to − 1.43). Three studies reported that significant adverse events were not associated with topical magnesium. The trial sequential analysis suggested that there is adequate evidence supporting the efficacy of topical magnesium in preventing postoperative sore throat.

Conclusion

Our study suggests that preoperative topical magnesium can effectively prevent postoperative sore throat.

Trial registration

PROSPERO (CRD42018110019); registered 26 September, 2018.

Application topique de magnésium pour prévenir les maux de gorge liés à l’intubation chez les patients chirurgicaux adultes: revue systématique et méta-analyse

Résumé

Contexte

Les maux de gorge postopératoires ont un impact négatif sur la satisfaction et la récupération des patients. Nous avons réalisé une revue systématique et une méta-analyse afin d’examiner l’efficacité d’une administration topique préopératoire de sulfate de magnésium pour prévenir les maux de gorge postopératoires chez les patients adultes.

Méthode

Nous avons effectué une recherche dans les bases de données Medline, EMBASE, China National Knowledge Infrastructure et Cochrane Central Register of Controlled Trials de leur création au 6 octobre 2018. Nous avons inclus les études randomisées contrôlées ayant évalué l’efficacité et l’innocuité de l’application topique préopératoire de magnésium chez des patients adultes subissant une intubation endotrachéale pour l’anesthésie générale. Nous avons ensuite mis les données en commun à l’aide d’un modèle à effets aléatoires et réalisé une analyse séquentielle d’essai sur l’incidence des maux de gorge. Notre critère d’évaluation principal était l’incidence de maux de gorge à 24 h après la chirurgie / l’extubation. Nos critères d’évaluation secondaires comprenaient la sévérité des maux de gorge à 24 h après la chirurgie / l’extubation et les événements indésirables.

Résultats

Onze études randomisées contrôlées portant sur 1096 patients ont été incluses dans cette étude. L’application topique de magnésium a été associée à une incidence réduite de maux de gorge postopératoires (risque relatif, 0,31; intervalle de confiance [IC] 95 %, 0,21 à 0,45) ainsi qu’à une réduction de la sévérité des maux de gorge postopératoires (différence moyenne normalisée, − 2,66; IC 95 %, − 3,89 à − 1,43). Trois études ont rapporté que les événements indésirables importants observés n’étaient pas associés au magnésium en application topique. Selon l’analyse séquentielle de l’essai, les données probantes soutenant l’efficacité du magnésium en application topique pour prévenir les maux de gorge postopératoires sont adéquates.

Conclusion

Selon les résultats de notre étude, l’application préopératoire topique de magnésium est efficace pour prévenir les maux de gorge postopératoires.

Enregistrement de l’étude

PROSPERO (CRD42018110019); enregistrée le 26 septembre 2018.

Notes

Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Philip M. Jones, Associate Editor, Canadian Journal of Anesthesia.

Author contributions

Akira Kuriyama contributed to all aspects of this study, including study conception and design; acquisition, analysis, and interpretation of data; and drafting the article. Hirokazu Maeda and Rao Sun contributed to the acquisition and analysis of data and revision of the article.

Financial disclosures

None.

Supplementary material

12630_2019_1396_MOESM1_ESM.pdf (259 kb)
Supplementary material 1 (PDF 259 kb)
12630_2019_1396_MOESM2_ESM.pdf (154 kb)
Supplementary material 2 (PDF 154 kb)

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Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Emergency and Critical Care Center, Kurashiki Central HospitalOkayamaJapan
  2. 2.Department of Emergency MedicineSugita Genpaku Memorial Obama Municipal HospitalFukuiJapan
  3. 3.Department of Anesthesiology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyHubeiChina

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