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Meta-Analysis
. 2020 Nov 13;99(46):e23279.
doi: 10.1097/MD.0000000000023279.

Effect of magnesium sulfate on renal colic pain: A PRISMA-compliant meta-analysis

Liang-Fu Chen  1   2 , Chih-Hao Yang  1   2 , Ting-Yi Lin  3 , Po-Jia Pao  3 , Karen Chia-Wen Chu  1   2 , Chin-Wang Hsu  1   2 , Chyi-Huey Bai  4 , Ming-Hai Du  1   2 , Yuan-Pin Hsu  1   2   5
Affiliations
Meta-Analysis

Effect of magnesium sulfate on renal colic pain: A PRISMA-compliant meta-analysis

Liang-Fu Chen et al. Medicine (Baltimore). .

Abstract

Background: Magnesium sulfate (MgSO4) is widely used in analgesia for different conditions. Recent randomized controlled trials (RCTs) have evaluated the effects of MgSO4 on renal colic; however, this new evidence has not been synthesized. Thus, we conducted a systematic review and meta-analysis to assess the efficacy and safety of MgSO4 in comparison with control for renal colic.

Methods: PubMed, EMBASE, and Scopus databases were searched from inception to February 2020. We included RCTs that evaluated MgSO4 vs control for patients with renal colic. Data were independently extracted by 2 reviewers and synthesized using a random-effects model.

Results: Four studies with a total of 373 patients were analyzed. Intravenous MgSO4 15 to 50 mg/kg did not significantly reduce renal colic pain severity at 15 minutes (mean difference [MD] = 0.35, 95% confidence interval [CI] -0.51 to 1.21; 2 RCTs), 30 minutes (MD = 0.19, 95% CI -0.74 to 1.13; 4 RCTs), and 60 minutes (MD = -0.28, 95% CI -0.72 to 0.16; 3 RCTs) in comparison with controls. In patients who failed to respond to initial analgesics, intravenous MgSO4 15 mg/kg or 2 ml of 50% solution provided similar pain relief to ketorolac or morphine at 30 minutes (P = .90) and 60 minutes (P = .57). No significant hemodynamic changes were observed with short-term use of MgSO4 in these studies.

Conclusion: MgSO4 provides no superior therapeutic benefits in comparison with control treatments. MgSO4 may be used as a rescue medication in patients not responding to initial analgesics. The short-term use of MgSO4 did not affect hemodynamic values.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of the article selection process.
Figure 2
Figure 2
Risk of bias assessment of the included studies.
Figure 3
Figure 3
Meta-analysis evaluating the pain severity of renal colic after MgSO4 administration (A) at 15 minutes, (B) at 30 minutes, and (C) at 60 minutes.
Figure 4
Figure 4
Meta-analysis evaluating the pain severity of renal colic after MgSO4 administration in the subgroup with initial analgesic failure (A) at 30 minutes and (B) 60 minutes and in the subgroup with no initial analgesic (C) at 30 minutes.
See this image and copyright information in PMC

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