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胺用于脊椎外科手术中术后疼痛治疗:通过元分析和试验顺序分析进行系统审查
Anders Schou Tornøe1, Alison Holten Pind1, Christina Cleveland Westerdahl Laursen1
1Department of Anaesthesiology, Centre for Anaesthesiological Research, Zealand University Hospital, Køge, Denmark.
Acta anaesthesiologica Scandinavica
|July 19, 2023
概括
胺可以减少成年人脊柱手术后的阿片类药物使用,但对严重副作用的证据尚不确定. 需要进一步的研究来确认胺.
科学领域:
- 麻醉学和疼痛管理
- 手术结果研究研究.
- 药理干预药理干预
背景情况:
- 有效的术后疼痛管理对于接受脊柱手术的患者至关重要.
- 胺是一种潜在的止痛药,但其在这种情况下的疗效和安全性需要进行彻底的评估.
- 吸食阿片类药物和严重不良事件是治疗有效性和安全性的关键指标.
研究的目的:
- 评估术前胺对脊柱手术患者疼痛管理的有益和有害影响.
- 综合来自随机临床试验的关于胺对阿片类药物消费和严重不良事件的影响的证据.
主要方法:
- 在Medline,Embase和CENTRAL数据库进行系统的文献搜索,截至2023年2月15日.
- 包括随机临床试验,比较胺与安慰剂或脊柱手术没有干预.
- 使用元分析和试验序列分析 (TSA) 来评估24小时累积的阿片类药物消费和严重不良事件,以及偏差风险和GRADE评估.
主要成果:
- 包括28项随机临床试验,共有2110名参与者.
- 在成年人中,胺可显著降低24小时累计阿片类药物消费 (平均差异-17.57毫克),证据确定性较低.
- 在胺和对照组之间没有发现严重不良事件的显著差异 (风险比2.16),证据确定性非常低.
结论:
- 胺可以有效地减少经手术后的阿片类药物消耗,在接受脊髓手术的成年人中.
- 由于证据非常不确定的原因,胺对严重不良事件的潜在增加需要进一步调查.
- 目前的证据表明,减少阿片类药物的潜在益处,但强调需要对安全性进行谨慎解释.
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