评估外周和干部神经阻塞的随机临床试验中的主要结果和预期效果大小:系统的范围审查
Sandra Sorenson1, Sarah Sofie Bitsch Flyger1, Lasse Pingel1
1Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.
British journal of anaesthesia
|December 4, 2024
概括
本综述确定了对外围和骨干神经块的关键结果和效果大小. 在未来的试验中将这些标准化,可以提高区域麻醉研究的一致性.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 周围和骨干神经阻塞对于外科手术期间止痛至关重要.
- 确定临床相关的效果大小值对于研究设计和解释至关重要.
- 这种变化影响了样本大小的计算和对阻断疗效的理解.
研究的目的:
- 系统地审查对外围和干部神经阻断的随机临床试验中的初级结果和预期效果大小.
- 为了为区域麻醉中更加均的研究提供基础.
主要方法:
- 在Cochrane CENTRAL,Medline和Embase的随机试验的系统范围审查.
- 包括的研究集中在接受手术的成年人单次注射超声波引导的外周和骨干神经阻塞.
- 提取了关于主要结果,预期效应大小,样本大小计算和相对于预期效应的统计学意义的数据.
主要成果:
- 常见的初级结局包括疼痛,止痛药的使用,恢复质量和动员.
- 预期效果的中位数大小:用于阿片类药物消费的9毫克吗啡等价物,用于疼痛的NRS2分,用于QOR-40的10分和用于恢复质量的QOR-15的8分.
- 85-91%的试验报告了适当的样本大小计算;然而,24%的试验未能达到预期的效果大小.
结论:
- 已确定的结果和效果大小可以提高未来区域麻醉试验的一致性.
- 结果和效果大小的标准化将提高研究结果的可比性和可靠性.
- 这一概述有助于设计更强大的临床试验,以确定神经阻断的有效性.
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