胺治疗急性骨折的疼痛:随机对照试验的系统审查和元分析
João Pedro Campos Lima1, Gabriel Vieira Piredda, Elias Victor Nogueira Balbino Lima
1From the Department of Research (J.P.C.L.), Hospital São Vicente de Paulo, Bom Jesus do Itabapoana, Brazil; Department of Medicine (J.P.C.L., G.V.P., K.A.C.), UniREDENTOR/Afya, Itaperuna, Brazil; Department of Medicine (E.V.N.B.L.), Universidade Iguaçu, Itaperuna, Brazil; and Department of Orthopedics and Traumatology Professor Nova Monteiro (V.G.), Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil.
The journal of trauma and acute care surgery
|February 3, 2026
概括
胺在急性骨折中没有显著的缓解疼痛,但可能会减少阿片类药物需求. 增加神经系统和精神病的副作用需要仔细监测.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 创伤护理 创伤护理
背景情况:
- 急性骨折会带来严重的疼痛管理挑战.
- 评估像胺胺这样的新型止痛药对于改善患者的治疗结果至关重要.
- 系统审查和元分析为临床决策提供了强有力的证据.
研究的目的:
- 系统地审查和元分析胺胺在急性骨折中治疗疼痛的疗效和安全性.
- 评估胺对疼痛强度,止痛药需求,住院和患者满意度的影响.
- 在这个患者群体中识别和量化与胺使用相关的不良事件.
主要方法:
- 系统地搜索PubMed,Cochrane和Embase数据库,直到2025年7月.
- 包括14项随机对照试验 (RCT),其中包括1453名急性骨折的成年患者.
- 使用随机效应模型进行元分析,与对照组比较胺 (单疗或辅助剂).
主要成果:
- 在15分钟,30分钟或60分钟的疼痛强度上,胺和对照组之间没有统计学上显著的差异.
- 可比较的额外止痛要求,住院时间和患者满意度.
- 基胺增加了神经系统 (48% vs 16%) 和精神病 (14.6% vs 4%) 的不良事件,尽管总体不良事件类似.
结论:
- 胺在急性骨折疼痛的常规方法上表现出极少或没有任何优势.
- 与胺一起观察到一种减少额外止痛的趋势,包括阿片类药物消费.
- 神经系统和精神疾病不良事件的风险增加需要在胺治疗期间保持警的医疗监督.
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