地佐辛预防术后疼痛：一项随机对照试验的荟萃分析

Dezocine for Preventing Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Zhou Xuelong, Zhang Chenjing, Wang Min, Yu LiNa, Yan M

机构信息

Department of Anesthesiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

PLoS One. 2015 Aug 19;10(8):e0136091. doi: 10.1371/journal.pone.0136091. eCollection 2015.

DOI:10.1371/journal.pone.0136091

PMID:26287536

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4545891/

Abstract

BACKGROUND

Dezocine is considered to be an alternative medication for managing postoperative pain. The aim of this study was to assess the efficacy and safety of this drug in this regard.

METHODS

Medline, EMBASE and the Cochrane Central Register of Control Trials (CENTRAL) were searched to identify all randomized controlled trials (RCTs) that compare dezocine with placebo or dezocine with morphine on postoperative pain. The data were extracted and pooled using Mantel-Haenszel random effects model. Heterogeneity was tested using the I2 statistic with values >50% and Chi2 test with P ≤ 0.05 indicating obvious heterogeneity between the studies.

RESULTS

Seven trials evaluating 665 patients were included. The number of patients with at least 50% pain relief was increased (N = 234; RR 3.04, 95% CI 2.27 to 4.08) and physician (N = 465; RR 2.84, 95% CI 1.66 to 4.84) and patient satisfaction (N = 390; RR 2.81, 95% CI 1.85 to 4.26) were improved following the administration of dezocine compared with the placebo. The effects of dezocine were similar to those of morphine in terms of the number of patients reporting at least 50% pain relief within 2-6 h after surgery (N = 235; RR 1.29, 95% CI 1.15 to 1.46) and physician (N = 234; RR 1.18, 95% CI 0.93 to 1.49) and patient (N = 158; RR 1.33, 95% CI 0.93 to 1.92) satisfaction. While, the number of patients with at least 50% pain relief within 0-1 h after surgery increased following dezocine compared with morphine treatment (N = 79; RR 1.45, 95% CI 1.18 to 1.77). There was no difference in the incidence of postoperative nausea and vomiting (PONV) following dezocine treatment compared with the placebo (N = 391; RR 1.06, 95% CI 0.42 to 2.68) or morphine treatment (N = 235; RR 0.65, 95% CI 0.14 to 2.93).

CONCLUSION

Dezocine is a promising analgesic for preventing postoperative pain, but further studies are required to evaluate its safety.

摘要

背景

地佐辛被认为是一种用于管理术后疼痛的替代药物。本研究的目的是评估该药物在这方面的疗效和安全性。

方法

检索了医学期刊数据库（Medline）、荷兰医学文摘数据库（EMBASE）和考科蓝对照试验中心注册库（CENTRAL），以识别所有比较地佐辛与安慰剂或地佐辛与吗啡用于术后疼痛的随机对照试验（RCT）。使用曼特尔-亨泽尔随机效应模型提取并汇总数据。使用I²统计量检验异质性，I²值>50%以及卡方检验P≤0.05表明研究之间存在明显异质性。

结果

纳入了7项评估665例患者的试验。与安慰剂相比，使用地佐辛后，疼痛缓解至少50%的患者数量增加（N = 234；相对危险度3.04，95%置信区间2.27至4.08），医生（N = 465；相对危险度2.84，95%置信区间1.66至4.84）和患者满意度（N = 390；相对危险度2.81，95%置信区间1.85至4.26）得到改善。在术后2 - 6小时内报告疼痛缓解至少50%的患者数量（N = 235；相对危险度1.29，95%置信区间1.15至1.46）、医生（N = 234；相对危险度1.18，95%置信区间0.93至1.49）和患者（N = 158；相对危险度1.33，95%置信区间0.93至1.92）满意度方面，地佐辛的效果与吗啡相似。然而，与吗啡治疗相比，使用地佐辛后术后0 - 1小时内疼痛缓解至少50%的患者数量增加（N = 79；相对危险度1.45，95%置信区间1.18至1.77）。与安慰剂治疗（N = 391；相对危险度1.06，95%置信区间0.42至2.68）或吗啡治疗（N = 235；相对危险度0.65，95%置信区间0.14至2.93）相比，地佐辛治疗后术后恶心呕吐（PONV）的发生率没有差异。