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在新生儿过程性疼痛的阿片类药物
Mari Kinoshita1, Emma Olsson2, Franciszek Borys3
1Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.
The Cochrane database of systematic reviews
|June 23, 2023
概括
与安慰剂相比,阿片类药物可能会减少新生儿的手术疼痛,但可能会增加呼吸暂停的发作. 对于其他比较和危害的证据是不确定的,需要对新生儿疼痛管理进行进一步的研究.
科学领域:
- 新生儿护理 新生儿护理
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 新生儿由于诊断,治疗或手术原因而经历了许多痛苦的手术.
- 像吗啡,芬太尼和雷米芬太尼这样的阿片类药物通常用于新生儿疼痛,但可能会影响大脑发育.
- 非药物干预和其他药物是疼痛管理的替代选择.
研究的目的:
- 评估阿片类药物使用对经历手术疼痛的新生儿的益处和危害.
- 比较包括安慰剂,没有药物,非药物干预,其他止痛药/镇静剂,以及其他阿片类药物或给药途径.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 包括早产和到期的婴儿高达46周的月经后年龄暴露于程序性疼痛.
- 主要结局:使用经过验证的尺度和不良事件来评估疼痛. 用于评估证据确定性的GRADE方法.
主要成果:
- 与安慰剂 (中度至低确定性证据) 相比,阿片类药物可能会在手术期间降低疼痛评分 (PIPP/PIPP-R,NIPS).
- 阿片类药物可能会增加呼吸暂停的发作 (低确定性证据),非常不确定的证据表明白心脏和低血压.
- 对于与非药物干预或其他止痛药的比较,以及不同类型的阿片类药物或给药途径的比较,证据非常不确定.
结论:
- 与安慰剂相比,阿片类药物可能在新生儿手术期间提供缓解疼痛,确定性中等.
- 潜在的呼吸暂停发作增加需要仔细考虑.
- 关于其他比较和不良事件存在显著的不确定性,强调需要更多高质量的研究.
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