在老年人中治疗急性疼痛的布普伦诺芬:通过元分析进行系统性审查
Katherine Selman1,2, Sarah Perelman1,2, Caroline Blatcher1,2
1Department of Emergency Medicine, Cooper University Health Care, Camden, NJ, USA.
Pain medicine (Malden, Mass.)
|July 18, 2024
概括
布普伦诺芬在老年人急性疼痛方面显示出混合的结果,并未证明比其他止痛药更优越. 需要未来的研究来探索其在这个人群中的潜力.
科学领域:
- 老年医学 老年医学
- 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:
- 部分阿片类药物激动剂布普伦诺芬正在作为急性疼痛管理中全激动剂的替代品被探索.
- 对其在老年人 (≥60岁) 中使用的证据需要进行系统评估.
研究的目的:
- 系统地审查布普伦诺芬治疗老年人急性疼痛的安全性和有效性.
- 为了比较疼痛评分,不良事件,和阿片类药物消费之间的布普伦诺芬和其他止痛药.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane,CINAHL,Web of Science,Google Scholar) 中进行了全面的搜索.
- 包括22项涉及2610名患者的研究,分析通过各种途径 (神经阻塞,通过皮肤,IV / IM,舌下) 给药的布普伦诺芬.
- 分析的重点是24小时和7天的疼痛评分,以及恶心和吐的差异.
主要成果:
- 在不同研究中,布普伦诺芬的给药方式有所不同,包括神经阻塞,通过皮肤,IV/IM和舌下途径.
- 虽然50%的研究报告说,布普伦诺芬改善了疼痛控制,但分析显示,与24小时或7天的控制止痛相比,疼痛得分没有显著差异.
- 六项研究 (54.5%) 显示,用布普伦诺芬减少了阿片类药物消费,大多数研究中没有发现副作用的显著差异.
结论:
- 这一系统性审查发现,布普伦诺芬对老年人急性疼痛的替代性止痛药没有优越性.
- 混合的结果表明需要进一步的研究来澄清布普伦诺芬的作用,并优化其在老年疼痛管理中的使用.
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