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系统性审查和桃体切除术后疼痛管理的元分析
Katharina Geißler1, Daniel Scham2, Winfried Meißner3
1Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. katharina.geissler@med.uni-jena.de.
桃体切除术后有效的疼痛管理涉及使用类固醇和非类固醇抗炎药物 (NSAIDs). 静脉注射德克萨米他和手术前的levobupivacaine注射也显著减少桃体切除术后的疼痛.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 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:
- 桃体切除术是一种常见的外科手术.
- 桃体切除术后的术后疼痛是严重的,缺乏标准化的管理方案.
- 对接受桃体切除术的患者来说,有效的止痛仍然是一个挑战.
研究的目的:
- 系统地审查和分析各种药理干预措施在桃体切除术后治疗术后疼痛的有效性.
- 根据定量疼痛强度数据,确定最佳的疼痛管理策略.
主要方法:
- 从1908年到2019年,使用四个主要数据库 (Cochrane Library,Ovid,PubMed,Web of Science) 进行了系统的文献审查.
- 该审查遵循了系统审查和元分析 (PRISMA) 准则的首选报告项目,包括随机对照试验,审查和元分析.
- 用随机效应和固定效应模型分析数据,以评估24小时后的疼痛强度,以及手术后的1,3,7天.
主要成果:
- 静脉注射德克萨米他在手术期间显著降低了疼痛 (平均差异[MD]: -0.42).
- 在手术前向桃体区注射levobupivacaine可显著减轻疼痛,持续长达三天 (MD: -1.92).
- 非类固醇抗炎药物 (NSAIDs) 的手术前或手术内使用也显著降低了疼痛 (MD: -0.75).
结论:
- 类固醇和NSAID是有效的手术后疼痛管理的关键组成部分.
- 特殊的干预措施,如静脉注射德克萨米他和局部Levobupivacaine注射,显示出显著的止痛作用.
- 进一步的研究可能会完善桃体切除术患者的最佳多模式疼痛管理策略.
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