The effect of magnesium sulfate on emergence agitation in children undergoing general anesthesia: A systematic review and meta-analysis + 1 more (paired review)

Edition: March-April 2022

Shen QH, Xu-Shen, Lai L, Chen YJ, Liu K, Sun LJ

J Clin Anesth. 2022;78:110669. doi:10.1016/j.jclinane.2022.110669

  • Study type: Systematic review and meta-analysis
  • Methods: Incidence of emergence agitation (EA) in <18 year-olds receiving IV magnesium sulfate
  • Findings: 8 studies, 635 participants. Administration of magnesium sulfate during general anaesthesia did not affect the occurrence of EA in paediatric patients. However, magnesium sulfate can prolong the emergence time without adverse effects.

The effects of intraoperative magnesium sulfate administration on emergence agitation and delirium in pediatric patients: A systematic review and meta-analysis of randomized controlled trials.

Koo CH, Koo BW, Han J, Lee HT, Lim D, Shin HJ.

Paediatr Anaesth. 2022;32(4):522-530. doi:10.1111/pan.14352

  • Study type: Systematic review and meta-analysis
  • Methods: Incidence of emergence agitation in < 18 year-olds receiving IV magnesium sulfate
  • Findings: 10 studies, 712 participants. The administration of magnesium sulfate reduced the incidence and severity of emergence agitation or emergence delirium in paediatric patients after the use of general anaesthesia during surgery.

 

Take Home Message / Commentary

It was unclear to me why the Abu-Sinna 2011 and Bondok 2014 studies were excluded from the Shen et al. review, but the comparison of the two forest plots and their widely differing outcomes highlights the fallibility of even our most revered level of evidence.

Reviewed by Dr Philip Cheung

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