早期术后疼痛和肝脏手术后的阿片类药物使用:系统性审查和元分析
Yatao Liu1, Zhaohui Gao2, Xiaodong Su2
1Department of Anesthesiology and Operation, First Hospital of Lanzhou University, China.
The Journal of international medical research
|February 8, 2026
概括
一次静脉内注射吗啡可以有效地减少术后疼痛和肝切除后的阿片类药物使用. 这种方法提供早期止痛和阿片类药物节约的好处,而不会增加不良事件,可能有助于患者的康复.
科学领域:
- 麻醉学和疼痛管理
- 手术瘤学手术瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 切除肝脏后的术后疼痛管理具有挑战性,关于最佳止痛策略的持续辩论.
- 有效的疼痛控制对于患者的康复和减少腹部大手术后的并发症至关重要.
研究的目的:
- 为了评估单次静脉内注射吗啡与传统方法相比,在切除肝脏的患者中治疗术后疼痛的疗效.
- 在这个外科手术群体中评估内吗啡对阿片类药物节约的影响.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 搜索包括到2025年8月的PubMed,Embase,科学网和科克兰图书馆.
- 主要结局:手术后24小时的疼痛强度;次要结局:48/72小时的疼痛和累积的阿片类药物消费.
主要成果:
- 分析了11个涉及535名患者的RCT.
- 在24小时内,内吗啡显著降低了疼痛评分 (SMD = -0.64),24小时内阿片类药物消费量减少了11.6毫克吗啡等价物.
- 两组之间没有观察到48/72小时疼痛或不良事件的显著差异.
结论:
- 在肝切除后,单次静脉注射吗啡剂量提供了显著的早期止痛和阿片类药物节约益处.
- 这种方法看起来是安全的,如果将其整合到多式联络止痛计划中,可能会促进恢复.
- 需要进一步的研究,以优化注射剂量和患者选择内吗啡.
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