Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#adolescent #child #child-preschool #emergence-delirium #humans

Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis

Xie et al., 2017 | J Evid Based Med | Meta Analysis

Citation

Xie Min, Li Xiang-Kui, Peng Yu. Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis. J Evid Based Med. 2017-Feb;10(1):16-25. doi:10.1111/jebm.12230

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 MgSO4 and control groups. Two studies showed significant lower emergence agitation incidence in MgSO4 group (pooled OR = 0.18, 95% CI 0.07 to 0.48, P = 0.0006). Five studies showed rescue analgesia was reduced in MgSO4 group (RR = 0.53, 95% CI 0.31 to 0.91, P = 0.02). Laryngospasm was founded lower in MgSO4 group (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). CONCLUSION: 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.

Key Findings

Ten randomized controlled trials involving 665 participates published between 2003 and 2015 were included. Eight studies showed no different effect on pain scores between MgSO4 and control groups. Two studies showed significant lower emergence agitation incidence in MgSO4 group (pooled OR = 0.18, 95% CI 0.07 to 0.48, P = 0.0006). Five studies showed rescue analgesia was reduced in MgSO4 group (RR = 0.53, 95% CI 0.31 to 0.91, P = 0.02). Laryngospasm was founded lower in MgSO4 group (OR = 0.36, 95

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adolescent
  • Child
  • Child, Preschool
  • Emergence Delirium
  • Humans
  • Magnesium Sulfate
  • Postoperative Pain
  • Postoperative Complications
  • Publication Bias
  • Tonsillectomy

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: magnesium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09