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全关节置换术后用于疼痛控制的髂筋膜阻滞的有效性和安全性:一项荟萃分析。

The efficiency and safety of fascia iliaca block for pain control after total joint arthroplasty: A meta-analysis.

作者信息

Zhang Peng, Li Jifeng, Song Yuze, Wang Xiao

机构信息

Department of Orthopedics, Huaihe Hospital, Henan University, Henan, China.

出版信息

Medicine (Baltimore). 2017 Apr;96(15):e6592. doi: 10.1097/MD.0000000000006592.

Abstract

BACKGROUND

This meta-analysis aimed to perform a meta-analysis including randomized controlled trials (RCTs) to assess the efficiency and safety of fascia iliaca block (FIB) for pain control in patients undergoing total joint arthroplasty (TJA).

METHODS

A systematic search was performed in Medline (1966-2017.03), PubMed (1966-2017.03), Embase (1980-2017.03), ScienceDirect (1985-2017.03) and the Cochrane Library. Study evaluated the efficiency and safety of FIB in TJA was selected. Meta-analysis was performed using Stata 11.0 software.

RESULTS

Five randomized controlled trials (RCTs) including 270 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = -0.544, 95% CI: -0.806 to -0.281, P = .000) and 24 hours (SMD = -0.519, 95% CI: -0.764 to -0.273, P = .000), morphine equivalent consumption at 12 hours (SMD = -0.895, 95% CI: -1.164 to -0.626, P = .000) and 24 hours (SMD = -0.548, 95% CI:-0.793 to -0.303, P = .000). In addition, fewer adverse side effect was identified in FIB groups (RD = -0.139, 95% CI: -0.243 to -0.034, P = .009).

CONCLUSION

The application of fascia iliaca block could significantly reduce VAS scores and morphine consumption at 12 and 24 hours following total knee and hip arthroplasty. In addition, there were fewer adverse effects in FIB groups. Due to the limited quality of the evidence currently available, higher quality RCTs are required.

摘要

背景

本荟萃分析旨在纳入随机对照试验(RCT)进行荟萃分析,以评估髂筋膜阻滞(FIB)在全关节置换术(TJA)患者疼痛控制中的有效性和安全性。

方法

在Medline(1966 - 2017.03)、PubMed(1966 - 2017.03)、Embase(1980 - 2017.03)、ScienceDirect(1985 - 2017.03)和Cochrane图书馆进行系统检索。选取评估FIB在TJA中有效性和安全性的研究。使用Stata 11.0软件进行荟萃分析。

结果

五项随机对照试验(RCT)共270例患者符合纳入标准。本荟萃分析表明,在12小时(标准化均数差[SMD] = -0.544,95%可信区间[CI]:-0.806至-0.281,P = 0.000)和24小时(SMD = -0.519,95% CI:-0.764至-0.273,P = 0.000)的视觉模拟量表(VAS)评分、12小时(SMD = -0.895,95% CI:-1.164至-0.626,P = 0.000)和24小时(SMD = -0.548,95% CI:-0.793至-0.303,P = 0.000)的吗啡等效剂量消耗方面,组间存在显著差异。此外,FIB组的不良副作用较少(风险差[RD] = -0.139,95% CI:-0.243至-0.034,P = 0.009)。

结论

髂筋膜阻滞的应用可在全膝关节和髋关节置换术后12小时和24小时显著降低VAS评分和吗啡消耗量。此外,FIB组的不良反应较少。由于目前可用证据质量有限,需要更高质量的随机对照试验。

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