疼痛优化是否会影响重症患者的妄想结果? 一个系统审查和元分析协议
Amanda Y Leong1,2,3, Lisa Burry4,5, Kirsten M Fiest1,2,6
1Department of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
BMJ open
|January 23, 2024
概括
这一系统性审查和元分析调查了重症成人疼痛,止痛药使用和妄想之间的联系. 这些发现旨在为临床实践提供信息,并减少与妄想相关的不良结果.
科学领域:
- 临界护理医学 临界护理医学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 严重病情严重的成年人未经治疗的疼痛会导致PTSD和失眠等不良结果.
- 止痛药,虽然治疗疼痛,可能会带来风险,如性障碍症,幻觉和妄想.
- 疼痛和止痛药都是妄的潜在危险因素,这种情况与长时间住院和认知障碍有关.
研究的目的:
- 系统地审查和元分析疼痛或止痛药物与妄想发生,持续时间和严重程度之间的关系.
- 检查严重疾病的成年人群体,以了解在重症监护环境中的这些关联.
主要方法:
- 在多个数据库 (MEDLINE,EMBASE,CINAHL,Cochrane) 进行全面的文献搜索,截至2023年5月.
- 包括随机对照试验,近实验,观察队列和病例控制研究,涉及成人ICU患者报告疼痛,止痛药和妄想.
- 排除了酒精戒断妄想,麻醉出现妄想和动物/实验室研究;使用既有工具进行偏差风险评估;使用随机效应模型进行元分析.
主要成果:
- 该部分应在研究完成和数据综合后填写.
- 预期的结果将量化疼痛/止痛药和妄想指标之间的关联.
- 将对异质性和潜在偏差进行评估,以确保可靠的调查结果.
结论:
- 这一系统性审查和元分析将提供关键证据,证明疼痛和止痛药在严重病情成年人 Delirium 发展和进展中的作用.
- 预计这些发现将指导临床决策,用于重症监护室的疼痛管理和妄预防.
- 传播将通过会议演讲和同行评审的出版物进行.
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