title: Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Previous systematical reviews showed that systemic magnesium decreased postoperative pain and reduced morphine use without any reported serious adverse effects in adults. However, studies in children yielded different results. So we conducted a systematic review to evaluate the impact of magnesium sulfate on postoperative complications in children undergoing tonsillectomies.
  
  
  METHODS
  The PubMed, EMbase via OVID, CENTRAL, and WHO ICTRP were searched to identify randomized controlled trials that addressed the effect of magnesium for postoperative pain, agitation, and complications in children undergoing tonsillectomies. Two reviewers screened titles and abstracts for eligibility and assessed the quality of the included studies. The meta-analysis was performed using RevMan 5.3.
  
  
  RESULTS
  Ten randomized controlled trials involving 665 participates published between 2003 and 2015 were included. Eight studies showed no different effect on pain scores between MgSO4and control groups. Two studies showed significant lower emergence agitation incidence in MgSO4group (pooled OR = 0.18, 95% CI 0.07 to 0.48, P = 0.0006). Five studies showed rescue analgesia was reduced in MgSO4group (RR = 0.53, 95% CI 0.31 to 0.91, P = 0.02). Laryngospasm was founded lower in MgSO4group (OR = 0.36, 95% CI 0.13 to 0.96, P = 0.04). Postoperative nausea and vomiting was found no difference between two groups (OR = 1.23, 95% CI 0.70 to 2.18, P = 0.47).
  
  
  CONCLUSIONS
  Unlike the studies in adults, this review shows there is no statistically significant effect of perioperative use of magnesium in the postoperative pain control in children undergoing tonsillectomies. But it seems has benefits in reducing rescue analgesia, emergence agitation incidence, and laryngospasm.
authors: Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
authors: Min
authors: M
authors: Xie
authors: Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
authors: Xiang-Kui
authors: XK
authors: Li
authors: Department of Editorial, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
authors: Yu
authors: Y
authors: Peng
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000071257:Emergence Delirium / Q000188:drug therapy; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000188:drug therapy*; D017594:Publication Bias; D014068:Tonsillectomy / Q000009:adverse effects*
chemical_list: D008278:Magnesium Sulfate
keywords: Emergence agitation; laryngospasm; magnesium sulfate; postsurgical pain; tonsillectomies