The efficacy of magnesium sulphate in preventing laryngospasm in paediatric patients undergoing general anaesthesia: A systematic review and meta-analysis of randomised control trials

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#humans #laryngismus #anesthesia-general #magnesium-sulfate #randomized-controlled-trials-as-topic

The efficacy of magnesium sulphate in preventing laryngospasm in paediatric patients undergoing general anaesthesia: A systematic review and meta-analysis of randomised control trials

Rasheed et al., 2024 | Anaesth Crit Care Pain Med | Meta Analysis

Citation

Rasheed Mohammad Ahmed, Memon Danyal, ... Shiwani Haaris. The efficacy of magnesium sulphate in preventing laryngospasm in paediatric patients undergoing general anaesthesia: A systematic review and meta-analysis of randomised control trials. Anaesth Crit Care Pain Med. 2024-Oct;43(5):101413. doi:10.1016/j.accpm.2024.101413

Abstract

BACKGROUND: Laryngospasm is sustained closure of the airways and can be a life-threatening condition. Magnesium sulphate is postulated to reduce the incidence of laryngospasm if administered peri-operatively. This systematic review and meta-analysis was performed to assess the efficacy of magnesium sulphate in preventing peri-operative laryngospasm in paediatric patients undergoing non-cardiac surgery. METHODS: Four databases and a trial registry were searched. Inclusion criteria were paediatric patients undergoing general anaesthesia. Exclusion criteria were patients who underwent cardiopulmonary bypass during surgery. The intervention of interest was the peri-operative administration of magnesium sulphate. The intervention was compared to either a placebo or other pharmacological agent. The primary outcome was the incidence of laryngospasm. A meta-analysis of all studies was performed. Sub-group analysis was subsequently performed. RESULTS: A total of 953 patients from 13 trials were included in this study. Nine RCTs administered magnesium intravenously and 4 RCTs administered magnesium locally. Laryngospasm rates were 6% lower in the magnesium group (OR 0.48 [95% CI 0.25-0.96], p = 0.04) compared to control in the pooled data. Subgroup analysis showed laryngospasm rates were lower by 12.5% (Odds Ratio 0.26 [CI 0.09-0.76], p = 0.01) in the local magnesium group. Subgroup analysis of studies that only administered intravenous magnesium did not show a statistically significant difference in the incidence of laryngospasm (OR 0.73 [95% CI 0.33-1.63], p = 0.44). CONCLUSIONS: This review shows a potential role for magnesium in the prevention of laryngospasm in paediatric patients undergoing general anaesthesia. There is a correlation between local administration of magnesium and reduction in laryngospasm rates. Further studies are required to assess the efficacy of intravenous magnesium in prevention of laryngospasm. REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO); PROSPERO ID CRD42022307868 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022307868).

Key Findings

A total of 953 patients from 13 trials were included in this study. Nine RCTs administered magnesium intravenously and 4 RCTs administered magnesium locally. Laryngospasm rates were 6% lower in the magnesium group (OR 0.48 [95% CI 0.25-0.96], p = 0.04) compared to control in the pooled data. Subgroup analysis showed laryngospasm rates were lower by 12.5% (Odds Ratio 0.26 [CI 0.09-0.76], p = 0.01) in the local magnesium group. Subgroup analysis of studies that only administered intravenous magnes

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 953
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Laryngismus
  • Anesthesia, General
  • Magnesium Sulfate
  • Randomized Controlled Trials as Topic
  • Child
  • Child, Preschool
  • Infant
  • Treatment Outcome

Evidence Classification

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

Provenance

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