德克斯梅德托米丁在外周劳动止痛中的应用:随机对照试验的系统审查和元分析
Di Zhang1,2, Yanxia Sun1,2, Junfeng Li1,2
1Department of Anesthesiology, Beijing Hospital, National Center of Gerontology.
The Clinical journal of pain
|October 19, 2023
概括
德克斯梅德托米丁与外周产痛止痛剂相结合,改善了疼痛评分. 虽然它增加了母亲的肌风险,但对于母亲和婴儿来说似乎是安全的,在分娩期间提供更好的疼痛缓解.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 外周止痛是一种在分娩期间治疗疼痛的常见方法.
- 德克斯梅德托米丁是一种具有镇静和止痛功能的α-2上腺激动剂.
研究的目的:
- 系统地审查和评估德克斯梅德托米丁作为外围产痛止痛的辅助剂的疗效和安全性.
- 综合随机对照试验 (RCT) 关于德克斯梅德托米丁对疼痛缓解和分娩结果的影响的研究结果.
主要方法:
- 一个系统的审查和RCT的元分析,比较带有或没有德克斯梅托米丁的外周止痛.
- 在PubMed,Cochrane图书馆和Embase进行文献搜索,截至2022年11月1日.
- 主要结局:视觉模拟尺度 (VAS) 疼痛评分在2小时内;次要结局包括分娩时间,胎儿Apgar评分,带血液pH值,止痛剂量和副作用.
主要成果:
- 分析了8项涉及846名分娩参与者的RCT.
- 德克斯梅德托米丁在15分,30分,60分和90分钟后显著降低了VAS疼痛评分.
- 观察到的发病率较低,但母亲的胸发生频率更高. 其他结果显示没有显著差异.
结论:
- 德克斯梅德托米丁作为外围产痛止痛的辅助药物,有效地改善了母亲的疼痛缓解 (VAS分数).
- 这种组合似乎对分娩妇女和胎儿都是安全的,尽管母亲的胸心率有所增加.
- 进一步的研究可能是合理的,以优化其使用和管理潜在的副作用.
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