Related Experiment Video
Updated: Mar 13, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and
Min Xie1, Xiang-Kui Li1, Yu Peng2
1Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
Insights
Systemic magnesium sulfate did not significantly reduce postoperative pain in children after tonsillectomy. However, it may decrease the need for rescue analgesia, reduce emergence agitation, and lower the incidence of laryngospasm in pediatric patients.
Area of Science:
- Anesthesiology and Pain Management
- Pediatric Surgery
- Pharmacology
Background:
- Systemic magnesium has shown efficacy in reducing postoperative pain and opioid requirements in adults.
- Contradictory findings exist regarding its effectiveness in pediatric populations, particularly after tonsillectomy.
Purpose of the Study:
- To systematically review and evaluate the impact of magnesium sulfate on postoperative complications in children undergoing tonsillectomies.
- To synthesize evidence from randomized controlled trials (RCTs) on magnesium's role in pediatric tonsillectomy recovery.
Main Methods:
- Conducted a systematic literature search across major databases (PubMed, EMbase, CENTRAL, WHO ICTRP) for relevant RCTs.
- Included 10 RCTs involving 665 pediatric participants published between 2003 and 2015.
- Performed meta-analysis using RevMan 5.3 to assess outcomes such as pain, agitation, and complications.
Main Results:
- Magnesium sulfate showed no significant difference in postoperative pain scores compared to control groups.
- A significant reduction in emergence agitation incidence was observed with magnesium sulfate (pooled OR = 0.18).
- Reduced need for rescue analgesia (RR = 0.53) and lower incidence of laryngospasm (OR = 0.36) were noted with magnesium sulfate.
Conclusions:
- Perioperative magnesium sulfate does not appear to significantly improve postoperative pain control in pediatric tonsillectomy patients.
- Evidence suggests potential benefits of magnesium sulfate in reducing rescue analgesia requirements, emergence agitation, and laryngospasm in this population.
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.
