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Sulfato de magnesio en intubación orotraqueal sin relajantes musculares: revisión sistemática con meta-análisis y análisis secuencial de ensayos

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dc.contributor.advisorBareño Silva, José
dc.creatorLasso Andrade, Fabricio Andrés
dc.creator.degreeMagíster en Epidemiología
dc.creator.degreeLevelMaestría
dc.creator.degreetypeFull time
dc.date.accessioned2024-07-18T19:26:22Z
dc.date.available2024-07-18T19:26:22Z
dc.date.created2024-06-18
dc.descriptionEn anestesiología, el Sulfato de Magnesio actúa como sedante, analgésico y relajante muscular. La sedación se debe a la inhibición del receptor NMDA, reduciendo los requerimientos anestésicos halogenados y propofol. En analgesia, modula el estímulo nervioso y disminuye la liberación de catecolaminas, siendo eficaz en infusión intravenosa y epidural para reducir el dolor postoperatorio y el consumo de opioides. En la relajación muscular, puede sustituir a los bloqueadores neuromusculares, mejorando las condiciones de intubación sin afectar la hemodinámica. Metodología: Revisión sistemática de ensayos clínicos aleatorizados desde el 2000 hasta Julio de 2023, que se llevó a cabo siguiendo las directrices PRISMA (Preferred Reporting Ítems for Sistematic Review and Meta-Analysis), además se tuvo en cuenta las recomendaciones para revisiones sistemáticas del grupo Cochrane Back and Neck (CBN). Se evaluará y analizará la información de los artículos para probar las hipótesis planteadas, verificando el nivel de evidencia del cada artículo escogido. Resultados: La revisión sistemática abordó 5 ensayos clínicos con un total de 468 participantes. El meta-análisis reveló un riesgo relativo de 0.20 (IC del 95%: 0.11-0.36) para Sulfato de Magnesio vs. Solución Salina, indicando una reducción significativa del riesgo de condiciones de intubación clínicamente inaceptables. El análisis secuencial de ensayos sugiere que se necesitan más estudios (n=3442) para confirmar estos hallazgos. La certeza de la evidencia, evaluada mediante GRADE, se clasificó como "Moderada" para condiciones de intubación clínicamente inaceptables y "Alta" para condiciones de intubación orotraqueal. Conclusión: El uso de Sulfato de Magnesio en infusión, por al menos, 10 minutos previo a la inducción en pacientes sometidos a cirugía electiva para intubación orotraqueal es eficaz para evitar condiciones de intubación clínicamente inaceptables cuando se compara con placebo.
dc.description.abstractIn anesthesiology, Magnesium Sulfate acts as a sedative, analgesic and muscle relaxant. Sedation is due to the inhibition of the NMDA receptor, reducing the requirements for halogenated anesthetics and propofol. In analgesia, it modulates the nervous stimulus and decreases the release of catecholamines, being effective in intravenous and epidural infusion to reduce postoperative pain and opioid consumption. In muscle relaxation, it can replace neuromuscular blockers, improving intubation conditions without affecting hemodynamics. Methodology: Systematic review of randomized clinical trials from 2000 to July 2023, which was carried out following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, and the group's recommendations for systematic reviews were also taken into account. Cochrane Back and Neck (CBN). The information from the articles will be evaluated and analyzed to test the proposed hypotheses, verifying the level of evidence of each chosen article. Results: The systematic review addressed 5 clinical trials with a total of 468 participants. The meta-analysis revealed a relative risk of 0.20 (95% CI: 0.11-0.36) for Magnesium Sulfate vs. Saline Solution, indicating a significant reduction in the risk of clinically unacceptable intubation conditions. Trial sequential analysis suggests that further studies (n=3442) are needed to confirm these findings. The certainty of the evidence, assessed using GRADE, was classified as 'Moderate' for clinically unacceptable intubation conditions and 'High' for orotracheal intubation conditions. Conclusion: The use of Magnesium Sulfate infusion for at least 10 minutes prior to induction in patients undergoing elective surgery for orotracheal intubation is effective in avoiding clinically unacceptable intubation conditions when compared with placebo.
dc.format.extent56 PP
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_43073
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/43073
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentEscuela de Medicina y Ciencias de la Saludspa
dc.publisher.programMaestría en Epidemiologíaspa
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectMagnesium Sulfate
dc.subjectRocuronium
dc.subjectIntubation Intratracheal
dc.subjectIntubation
dc.subjectNeuromuscular Blocking Agents
dc.subjectMagnesium Sulfate
dc.subject.keywordRocuronium
dc.subject.keywordMagnesium Sulfate
dc.subject.keywordIntubation Intratracheal
dc.subject.keywordIntubation
dc.subject.keywordNeuromuscular Blocking Agents
dc.titleSulfato de magnesio en intubación orotraqueal sin relajantes musculares: revisión sistemática con meta-análisis y análisis secuencial de ensayos
dc.title.TranslatedTitleMagnesium sulfate in orotracheal intubation without muscle relaxants: systematic review with meta-analysis and sequential analysis of trials
dc.typebachelorThesis
dc.type.documentTrabajo de grado
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de grado
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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Maestría en Epidemiología