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疼痛控制剂对儿科桃体切除术的影响:系统性审查和网络元分析
Do Hyun Kim1, David W Jang2, Se Hwan Hwang3
1Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
概括
布洛芬有效地控制了儿科桃体切除术的疼痛,而青在减少出血和恶心方面显示出有前途. 凯托洛拉克可以减轻恶心,但增加出血风险,需要进一步研究以获得最佳的疼痛管理.
科学领域:
- 麻醉学和疼痛管理
- 儿科手术 儿科手术
- 基于证据的医学 基于证据的医学
背景情况:
- 桃体切除术是一种常见的儿科手术手术.
- 有效的疼痛管理和尽量减少疾病是桃体切除术后至关重要的.
- 使用各种止痛药,但它们在儿童中的比较有效性和安全性尚未完全确立.
研究的目的:
- 系统地审查和网络元分析随机对照试验.
- 评估小儿桃体切除术患者的术后止痛药的效果和发病率.
- 为了比较术后出血,恶心/吐和止痛药摄入的发生率.
主要方法:
- 随机对照试验的系统审查和网络元分析 (NMA).
- 包括接受桃体切除术的儿科患者.
- 帕拉西托醇,帕拉西托醇与阿片类药物,布洛芬,凯托洛拉克,阿片类药物和安慰剂/盐水相比较.
主要成果:
- 与对照组相比,没有止痛药显著增加了术后出血.
- 布洛芬显著减少了对额外止痛药的需求.
- 降醇,易布洛芬和凯托洛拉克显示了下降术后恶心和吐 (PONV) 的趋势.
结论:
- 布洛芬似乎最有效的术后疼痛缓解.
- 降醇在减少出血,PONV和止痛药需求方面表现出有利的趋势.
- 凯托洛拉克对PONV的潜在益处被增加出血的趋势所抵消;需要进一步研究.
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