治疗术后疼痛的先进性乙氨基 (PAPP):更新的元分析
Brett Doleman1, Síle Ann Johnson1, Daniel Last1
1Department of Anaesthetics, Royal Derby Hospital, Derby, United Kingdom; Anaesthesia, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.
概括
在手术前开始的预防性乙氨基,减少了成年人24小时的阿片类药物消费和术后吐. 这一更新的元分析提供了证据证明其在治疗手术疼痛方面的有效性,尽管证据的确定性很低.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 手术后的疼痛是手术后的一大挑战.
- 预防性止痛,在切口前给予疼痛缓解,是缓解这种疼痛的策略.
- 以前的研究表明,预防性乙氨基的潜在益处,但证据确定性有限.
研究的目的:
- 进行更新的元分析,比较先发性乙胺和切口后的乙胺.
- 评估预防性乙氨基在减少术后疼痛和阿片类药物消耗方面的疗效.
- 评估接受手术的成年患者的疗效,特别是椎手术等高风险人群.
主要方法:
- 随机对照试验的系统审查和元分析.
- 包括一个未发表的随机,安慰剂控制,双盲试验.
- 搜索电子数据库,查找有关预防性乙氨基干预的相关研究.
主要成果:
- 包括12项研究,共845名参与者.
- 在预防组中发现24小时吗啡消耗减少 (平均差异-2.42毫克).
- 观察到手术后吐减少 (风险比0.56) 与先发制人的乙氨基.
- 在止痛要求的时间没有显著差异,疼痛得分在6/24小时,或.
- 所有评估的结果都具有非常低的证据确定性.
结论:
- 预防性乙氨基显著降低了24小时的阿片类药物消费.
- 乙氨基的预防性使用也降低了手术后吐的发生率.
- 尽管有积极的发现,但对所有评估结果的证据确定性非常低.
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