国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
9期
799-801,842
,共4页
地佐辛%芬太尼%术后镇痛%Meta分析
地佐辛%芬太尼%術後鎮痛%Meta分析
지좌신%분태니%술후진통%Meta분석
Dezocine%Fentanyl%Postoperative pain%Meta-analysis
目的 系统评价地佐辛、芬太尼两组配伍术后镇痛的临床效果及安全性. 方法 计算机检索PubMed、Embase、CNKI、VIP和Wanfang Data查找有关地佐辛及芬太尼用于术后静脉自控镇痛的随机对照试验(randomization controlled clinical trial,RCT),文献起止时限均从建库至2013年6月,逐个进行质量评价和资料提取,然后采用RevMan5.2软件进行Meta分析. 结果 最终纳入13个RCT,共1 090例.Meta结果显示:①有效性:术后静脉泵注地佐辛视觉模拟评分(visualanalogue scale,VAS)在2、24 h明显低于芬太尼组[标准化均数差(standardized mean difference,SMD),95％置信区间(confidence interval,CI)分别为-0.17(-0.25,-0.09),-0.08(-0.13,-0.03)](P＜0.05),术后4 h Ramsay评分地佐辛组低于芬太尼组[SMD(95％ CI)为-0.25(-0.34,-0.15)](P＜0.05),但两组间在术后l、4、12、48 h的VAS评分差异并无统计学意义.②安全性:术后静脉泵注地佐辛组在术后发生恶心呕吐、呼吸抑制、嗜睡、皮肤瘙痒、尿潴留的例数明显低于芬太尼组[比值比(odds ratio,OR) (95％ CI)分别为0.26(0.17,0.39)、0.11 (0.03,0.34)、0.28(0.06,0.50)、0.14(0.05,0.34)、0.29(0.16,0.54)] (P＜0.05).结论 术后静脉泵注地佐辛和芬太尼均能降低患者术后疼痛程度,同时地佐辛能降低副作用的发生率.
目的 繫統評價地佐辛、芬太尼兩組配伍術後鎮痛的臨床效果及安全性. 方法 計算機檢索PubMed、Embase、CNKI、VIP和Wanfang Data查找有關地佐辛及芬太尼用于術後靜脈自控鎮痛的隨機對照試驗(randomization controlled clinical trial,RCT),文獻起止時限均從建庫至2013年6月,逐箇進行質量評價和資料提取,然後採用RevMan5.2軟件進行Meta分析. 結果 最終納入13箇RCT,共1 090例.Meta結果顯示:①有效性:術後靜脈泵註地佐辛視覺模擬評分(visualanalogue scale,VAS)在2、24 h明顯低于芬太尼組[標準化均數差(standardized mean difference,SMD),95％置信區間(confidence interval,CI)分彆為-0.17(-0.25,-0.09),-0.08(-0.13,-0.03)](P＜0.05),術後4 h Ramsay評分地佐辛組低于芬太尼組[SMD(95％ CI)為-0.25(-0.34,-0.15)](P＜0.05),但兩組間在術後l、4、12、48 h的VAS評分差異併無統計學意義.②安全性:術後靜脈泵註地佐辛組在術後髮生噁心嘔吐、呼吸抑製、嗜睡、皮膚瘙癢、尿潴留的例數明顯低于芬太尼組[比值比(odds ratio,OR) (95％ CI)分彆為0.26(0.17,0.39)、0.11 (0.03,0.34)、0.28(0.06,0.50)、0.14(0.05,0.34)、0.29(0.16,0.54)] (P＜0.05).結論 術後靜脈泵註地佐辛和芬太尼均能降低患者術後疼痛程度,同時地佐辛能降低副作用的髮生率.
목적 계통평개지좌신、분태니량조배오술후진통적림상효과급안전성. 방법 계산궤검색PubMed、Embase、CNKI、VIP화Wanfang Data사조유관지좌신급분태니용우술후정맥자공진통적수궤대조시험(randomization controlled clinical trial,RCT),문헌기지시한균종건고지2013년6월,축개진행질량평개화자료제취,연후채용RevMan5.2연건진행Meta분석. 결과 최종납입13개RCT,공1 090례.Meta결과현시:①유효성:술후정맥빙주지좌신시각모의평분(visualanalogue scale,VAS)재2、24 h명현저우분태니조[표준화균수차(standardized mean difference,SMD),95％치신구간(confidence interval,CI)분별위-0.17(-0.25,-0.09),-0.08(-0.13,-0.03)](P＜0.05),술후4 h Ramsay평분지좌신조저우분태니조[SMD(95％ CI)위-0.25(-0.34,-0.15)](P＜0.05),단량조간재술후l、4、12、48 h적VAS평분차이병무통계학의의.②안전성:술후정맥빙주지좌신조재술후발생악심구토、호흡억제、기수、피부소양、뇨저류적례수명현저우분태니조[비치비(odds ratio,OR) (95％ CI)분별위0.26(0.17,0.39)、0.11 (0.03,0.34)、0.28(0.06,0.50)、0.14(0.05,0.34)、0.29(0.16,0.54)] (P＜0.05).결론 술후정맥빙주지좌신화분태니균능강저환자술후동통정도,동시지좌신능강저부작용적발생솔.
Objective To systematically evaluate the efficacy and safety of injected dezocine and fentanyl for postoperative pain.Methods Data was electronically searched in the PubMed,Embase,CNKI,VIP and Wanfang Data databases from the library literature start-stop time until June 2013 to identify randomization controlled clinical trial (RCT) about dezocine and fentanyl for postoperative patient-comtrolled intravenous analgesia.The methodological qualities of included RCTs were assessed.The RCTs were evaluated using the RevMan5.2 software.Results Thirteen RCTs involving 1 090 patients met the inclusion criteria.The results of meta-analyses showed that:① Efficacy:the VAS scores were significantly lower within postoperative 2 h and 24 h in the dezocine group than those in the fentanyl group {standardized mean difference(SMD) [95％ confidence interval (CI) were 0.17 (-0.25,-0.09),-0.08 (-0.13,-0.03),respectively]}(P＜0.05).The Ramsay scores at 4 h were significantly lower in the dezocine group than those in the fentanyl group [SMD (95％ CI)was-0.25 (-0.34,-0.15)](P＜0.05).However,there were no significant differences with the visual analogue interval(VAS) at 1,4,12 h or 48 h.② Safety:the incidence of nausea and vomiting,respiratory depression,lethargy,pruritus and urinary retention were significantly lower in the dezocine group than those in the fentanyl group [odds ratio (OR)(95％ CI) were 0.26 (0.17,0.39),0.11 (0.03,0.34),0.28 (0.06,0.50),0.14 (0.05,0.34),0.29(0.16,0.54),respectively] (P＜0.05).Conclusions The available clinical data indicate that postoperative use of dezocine and fentanyl can reduce postoperative pain significantly,and dezocine could reduce the incidence of adverse reactions significantly.
