Isiordia-Espinoza Mario Alberto, de Jesús Pozos-Guillén Amaury, Aragon-Martinez Othoniel Hugo
Lab of Basic Sciences, Faculty of Stomatology, Autonomous University of San Luis Potosi, S.L.P., Mexico.
Lab of Basic Sciences, Faculty of Stomatology, Autonomous University of San Luis Potosi, S.L.P., Mexico.
Br J Oral Maxillofac Surg. 2014 Nov;52(9):775-83. doi: 10.1016/j.bjoms.2014.05.005. Epub 2014 Jun 13.
The aim of this systematic review and meta-analysis was to evaluate published randomised, double-blind, clinical trials to compare the analgesic efficacy and safety of tramadol with that of non-steroidal anti-inflammatory drugs (NSAID) in operations on the third molars. We identified eligible reports from searches of PubMed, MedLine, the Cochrane Library, Oxford Pain Relief database, Imbiomed, and Google Scholar. The full text of studies that met our minimum requirements were evaluated using inclusion and exclusion criteria with the Oxford Quality Scale. Those with a Score ≥ 3 in this scale were included and their data were extracted and analysed. Absolute increase in risk, the number needed to harm, odds ratio and 95% CI were calculated using Risk Reduction Calculator software. Each meta-analysis was made with the help of the Mantel-Haenszel random effects model, estimates of risk (odds ratio (OR)) and 95% CI were calculated using the Review Manager 5.2. from the Cochrane Library. A significant risk was assumed when the lower limit of the 95%CI was greater than 1. Probabilities of less than 0.05 were accepted as significant. The results showed that tramadol had less analgesic efficacy and an increased risk of adverse effects compared with NSAID. In conclusion, a single dose of tramadol was not as effective or as safe as NSAID for the relief of pain after operations on the third molars.
本系统评价和荟萃分析的目的是评估已发表的随机、双盲临床试验，以比较曲马多与非甾体抗炎药（NSAID）在第三磨牙手术中的镇痛效果和安全性。我们通过检索PubMed、MedLine、Cochrane图书馆、牛津疼痛缓解数据库、Imbiomed和谷歌学术搜索确定了符合条件的报告。使用牛津质量量表的纳入和排除标准对符合我们最低要求的研究全文进行评估。在此量表中得分≥3的研究被纳入，其数据被提取并分析。使用风险降低计算器软件计算风险的绝对增加、伤害所需人数、比值比和95%置信区间。每项荟萃分析均借助Mantel-Haenszel随机效应模型进行，使用Cochrane图书馆的Review Manager 5.2计算风险估计值（比值比（OR））和95%置信区间。当95%置信区间的下限大于1时，认为存在显著风险。概率小于0.05被认为具有显著性。结果表明，与NSAID相比，曲马多的镇痛效果较差，不良反应风险增加。总之，单剂量曲马多在缓解第三磨牙手术后疼痛方面不如NSAID有效和安全。
