静脉内吗啡的非肺性并发症:一个系统的审查和元分析与元回归
Yves Renard1, Kariem El-Boghdadly2, Jean-Benoît Rossel3
1Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
British journal of anaesthesia
|August 4, 2024
概括
在手术或分娩后,静脉内吗啡增加了恶心,吐和尿路留等副作用. 这些并发症发生不论所服用的吗啡剂量如何.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 内吗啡是有效的手术止痛药,但有关于副作用的担忧.
- 实施受到潜在不良事件的限制.
- 一项系统性审查旨在确定并发症的剂量值.
研究的目的:
- 为了确定是否存在从静脉内吗啡引起的非肺性并发症的门剂量.
- 调查内吗啡剂量与并发症率之间的关联.
- 分析术后和产科疼痛缓解中的并发症.
主要方法:
- 随机对照试验的系统审查和元分析.
- 包括接受手术或分娩的患者.
- 分析结果:手术后恶心和吐,,24小时内尿液保留.
- 剂量类别:1-100 微克,101-200 微克,201-500 微克,>500 微克.
主要成果:
- 包括168项试验,包括9917名患者.
- 内吗啡显著增加了恶心/吐 (OR 1.52), (OR 6.11) 和尿 (OR 1.73).
- 超回归没有发现剂量和并发症率 (剂量独立) 之间的关联.
- 根据手术类型没有分组差异.
- 证据质量很低 (GRADE).证据质量很低.
结论:
- 内吗啡显著增加了术后的恶心和吐,和尿.
- 这些并发症以剂量独立的方式发生.
- 由于证据质量不佳,可能需要进一步的研究.
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