迪克洛芬雅克用于治疗儿童急性术后疼痛
Martin Ringsten1,2, Tamara Kredo3, Sumayyah Ebrahim3,4
1Department of Health Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
The Cochrane database of systematic reviews
|December 11, 2023
概括
迪克洛芬雅克用于小儿术后疼痛的使用显示了不确定的益处和危害. 与阿片类药物相比,它可以减少恶心,但也增加出血风险,整体证据质量非常低.
科学领域:
- 儿科手术 儿科手术
- 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:
- 急性术后疼痛在儿童中很常见,影响了恢复.
- 非类固醇抗炎药物 (NSAIDs),如迪克洛菲纳克,用于疼痛和炎症.
- 关于迪克洛菲纳克在治疗儿科术后疼痛方面的疗效和安全性存在不确定性.
研究的目的:
- 评估迪克洛芬雅克在治疗儿童急性术后疼痛方面的有效性和安全性.
- 比较包括安慰剂,其他活性疗法和不同的迪克洛芬雅克施用方法.
- 这项研究旨在澄清儿科疼痛管理的益处和危害.
主要方法:
- 使用Cochrane搜索方法对随机对照试验 (RCT) 的系统审查.
- 包括接受手术的18岁以下儿童,将狄克洛芬雅与安慰剂或活性比较剂进行比较.
- 主要结局:缓解疼痛,疼痛强度,不良事件和严重不良事件.
主要成果:
- 分析了32个涉及2250名儿童的RCT;大多数具有偏差的高风险.
- 对迪克洛芬雅克与安慰剂的证据在恶心,吐和出血方面非常不确定.
- 与阿片类药物相比,迪克洛菲纳克可能会减少恶心,但会增加出血;证据中等.
- 与类醇或布皮瓦卡因相比,关于迪克洛芬雅克疗效和安全性的证据非常不确定.
结论:
- 由于报告和试验质量不佳,迪克洛菲纳克治疗儿科术后疼痛的有效性和安全性仍然不确定.
- 迪克洛菲纳克可能比阿片类药物提供更少的恶心,但携带更高的出血风险.
- 临床决策应权衡已知的药理效应,而不是不确定的疗效数据.
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