对阿片类药物与非阿片类药物在急性胰腺炎中的系统审查和元分析
Alfred D Nelson1, Nahyr Sofía Lugo-Fagundo2, Soumya Jagannath Mahapatra3
1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Gastro hep advances
|August 12, 2024
概括
与阿片类药物相比,非阿片类药物,包括NSAID和,有效地管理急性胰腺炎的疼痛,而不会增加不良事件或需要额外的止痛药. 对于最佳的疼痛控制策略,需要进一步的研究.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 腹痛是急性胰腺炎 (AP) 的首要诊断标准.
- 医院缺乏管理AP相关疼痛的标准指南.
- 这项研究解决了在AP中基于证据的疼痛管理的需要.
研究的目的:
- 进行一个比较非阿片类和阿片类止痛药在急性胰腺炎的疼痛管理的元分析.
- 在AP患者中评估不同类别的止痛药的疗效和安全性.
主要方法:
- 在2021年5月之前,对随机对照试验 (RCT) 进行了系统搜索.
- 使用几率比率 (OR) 和95%置信区间 (CI) 评估有效性.
- 七个涉及389名患者的RCT被纳入了分析.
主要成果:
- 在非阿片类药物和阿片类药物之间没有观察到第一天疼痛强度的显著差异 (OR 0.82,95% CI -2.55至4.19).
- 与阿片类药物相比,非阿片类药物显示需要补充止痛药的风险更高 (OR 3.87,95% CI 1.25-12.04),但当排除普卡因试验时,这并不重要.
- 与非阿片类药物相比,阿片类药物没有增加并发症,恶心,吐,镇静或死亡.
结论:
- 非阿片类止痛药,特别是NSAID和,为AP提供足够的疼痛缓解.
- 非阿片类药物在不良事件和补充止痛药使用方面表现出与阿片类药物相似的安全性.
- 建议进行进一步的研究,以优化非阿片类药物的单独使用或与阿片类药物结合使用,以获得更好的AP疼痛控制.
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