作为外围神经阻塞的辅助剂,甲和德克斯梅托米丁的联合作用:通过元分析和试验顺序分析进行系统性审查
Mathias Maagaard1, Jakob Hessel Andersen2, Pia Jaeger3
1Anaesthesiology, Zealand University Hospital, Koge, Denmark mathias.maagaard@gmail.com.
Regional anesthesia and pain medicine
|January 22, 2024
概括
与安慰剂或单独使用德克斯梅托米丁相比,结合德克萨米和德克斯梅托米丁可能会延长疼痛缓解的持续时间. 然而,它提供与单独使用德甲类似的益处,这表明德甲可能足以缓解长期的疼痛.
科学领域:
- 麻醉学和药理学 麻醉学和药理学
- 疼痛管理研究 疼痛管理研究
背景情况:
- 德克萨梅他和德克斯梅托米丁对外围神经阻塞持续时间的联合作用尚未得到充分证实.
- 了解长期止痛的附加剂对于手术患者的护理至关重要.
研究的目的:
- 系统地审查和对随机对照试验 (RCT) 的元分析,评估对外围神经阻塞的德克萨米他和德克斯梅多米丁的组合.
- 为了确定这种组合对术后止痛的持续时间的影响.
主要方法:
- 从主要数据库中对9个RCT (14个比较) 进行系统审查,这些RCT在2023年6月8日之前发表.
- 进行了元分析,试验顺序分析和偏差风险评估.
- 主要结局是镇痛的持续时间.
主要成果:
- 德克萨米他和德克斯米德托米丁的组合显著增加了疼痛缓解的持续时间,而不是安慰剂 (460分钟) 和德克斯米德托米丁 (388分钟).
- 在将组合剂与单独使用德甲 (50分钟) 进行比较时,没有观察到疼痛缓解持续时间的显著差异.
- 证据的确定性是适度的,因为在大多数纳入试验中存在高偏差风险.
结论:
- 与安慰剂和德克斯梅德托米丁相比,甲和德克斯梅德托米丁的联合可能会延长疼痛缓解的持续时间.
- 这种组合在延长疼痛缓解方面显示出与单独使用德克萨梅他类似的疗效.
- 德克萨米他作为唯一的辅助剂可能足以实现长时间的止痛,简化了麻醉方案.
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