摘要
目的采用Meta分析系统评价地佐辛复合氟比洛芬酯用于术后患者自控静脉镇痛(PCIA)的效果和安全性。方法在PubMed、EMBASE、CENTRAL、Web of Science、中国生物医学文献数据库、知网、万方数据库中进行文献检索,截止时间为2018年2月。纳入比较地佐辛复合氟比洛芬酯与舒芬太尼用于术后PCIA疗效和安全性的随机对照试验(RCT)。采用Jadad量表评估研究质量,采用Stata 14.0软件进行统计分析。结果共纳入15项中文RCTs。与舒芬太尼组比较,地佐辛复合氟比洛芬酯组术后4h(SMD=-0.34,95%CI-0.64～-0.04,P=0.028)和12h(SMD=-0.26,95%CI-0.47～-0.06,P=0.013)的VAS疼痛评分,术后6h(SMD=-1.71,95%CI-3.28～-0.13,P=0.033)、12h(SMD=-0.71,95%CI-1.35～-0.07,P=0.029)和48h(SMD=-0.15,95%CI-0.29～-0.02,P=0.024)的Ramsay镇静评分均明显降低;术后24h的镇静泵按压次数明显减少(SMD=-1.67,95%CI-3.30～-0.05,P=0.043)。与舒芬太尼组比较,地佐辛复合氟比洛芬酯组不良事件如恶心呕吐、嗜睡、头晕、眩晕、头痛、皮肤瘙痒、寒战和出汗等发生率明显降低(OR均<0.5,P<0.05)。结论地佐辛复合氟比洛芬酯用于术后PCIA优于舒芬太尼,具有较好的镇痛效果,并且不良反应少。
Objective To systematically review the efficacy and safety of the combination therapy of dezocine with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia(PCIA)management.Methods A literature search was performed in databases such as PubMed,EMBASE,CENTRAL,Web of Science,Chinese biomedical literature service system(Sinomed),China National Knowledge Infrastructure(CNKI)and WanFang up to Feb,2018.Only randomized controlled trails(RCTs)comparing the efficacy and safety of dezocine plus flurbiprofen axetil with sufentanil on PCIA were eligible for the Meta-analysis.The Jadad scale was utilized to evaluate study quality.The Stata 14.0 software was used to perform statistical analysis.Results Fifteen Chinese RCTs were included in this Meta-analysis.Compared with sufentanil group,dezocine plus flurbiprofen axetil group had a significantly lower visual analogue score(VAS)at postoperative 4h[standardized mean differences(SMD)=-0.34,95% CI-0.64 to -0.04,P =0.028]and 12h(SMD =-0.26,95% CI-0.47 to -0.06,P=0.013);a significantly reduced Ramsay sedation score at postoperative 6h(SMD=-1.71,95% CI-3.28 to -0.13,P=0.033),12h(SMD=-0.71,95% CI-1.35to-0.07,P=0.029)and 48h(SMD=-0.15,95% CI-0.29to-0.02,P=0.024);and a significantly less times of pressing analgesia pump at postoperative 24h(SMD =-1.67,95% CI-3.30 to -0.05,P =0.043).Furthermore,compared with sufentanil group,dezocine plus flurbiprofen axetil group significantly reduced incidences of adverse effects such as nausea/vomiting,drowsiness,dizziness/vertigo/headache,skin itch,shivering and sweat [odds ratio(OR)<0.5,P<0.05].Conclusion The combination of dezocine with flurbiprofen axetil is superior over sufentanil for preventing pain on postoperative PCIA in China.
作者
段满林
张嵬
徐建国
DUAN Manlin;ZHANG Wei;XU Jianguo(Department of Anesthesiology Jinling Hospital of Nanjing University Medical School,Nanjing 210002,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2018年第12期1213-1217,共5页
Journal of Clinical Anesthesiology
关键词
地佐辛
氟比洛芬酯
舒芬太尼
患者自控静脉镇痛
Dezocine
Flurbiprofen axetil
Sufentanil
Patient-controlled intravenous analgesia
