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在关节整形术中基于阿片类药物和无阿片类药物的止痛:系统性审查和元分析

Omar Saeed¹, Abdelrahman Saeed¹, Mohamedhen Vall Nounou²

¹Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Anaesthesia, critical care & pain medicine

|February 9, 2026

概括

关节整形术后的无阿片类药物疼痛管理显著降低了疼痛评分和阿片类药物相关的副作用,如恶心和. 这种方法为传统的阿片类药物治疗方案提供了更安全的替代方案,改善了患者的治疗结果.

科学领域:

整形外科手术整形外科手术
疼痛管理疼痛管理
麻醉学麻醉学

背景情况:

关节整形术是关节疼痛缓解的常见手术.
从历史上看,阿片类药物是术后疼痛的标准,但人们对依赖和不良事件的担忧正在增加.
在关节整形术中,越来越多的趋势是针对无阿片类药物疼痛管理策略.

研究的目的:

在关节整形中,系统地审查和比较基于阿片类药物和无阿片类药物的术后疼痛管理方案之间的患者结果.
与基于阿片类药物的方法相比,评估无阿片类药物的镇痛疗法的疗效和安全性.

主要方法:

在主要数据库 (PubMed,科学网,Scopus,Cochrane Central) 进行系统的文献搜索,截至2025年5月.
包括随机临床试验,比较成年关节整形术患者的阿片类药物和无阿片类药物治疗方案.
共同初级结局:休息和运动视觉模拟尺度 (VAS) 疼痛评分;二级结局包括恶心,吐,,阿片类药物消费和其他不良事件.

主要成果:

包括28项涉及1787名患者的试验.
没有阿片类药物的治疗方案在12小时和24小时显著降低了运动VAS疼痛得分 (MD -1.43,p=0.022;MD -1.18,p=0.032).
与以阿片类药物为基础的组相比,无阿片类药物组在12小时和24小时内也报告了明显较低的静止VAS疼痛得分 (MD -1.51,p=0.032;MD -1.12,p=0.008).

结论:

无阿片类药物治疗方案与关节整形术患者的VAS疼痛得分降低有关,尽管观察到的变化.
无阿片类药物止痛药有效降低了术后副作用,特别是阿片类药物引起的恶心和.
两组之间在吐,头痛,尿液保留,抗使用或整体患者满意度方面没有发现显著差异.

关键词:

关节整形术关节整形术基于阿片类药物的止痛药.没有阿片类药物的止痛药.

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