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腹腔镜胆囊切除术后静脉输注利多卡因用于疼痛控制:一项随机对照试验的荟萃分析。

Intravenous lidocaine infusion for pain control after laparoscopic cholecystectomy: A meta-analysis of randomized controlled trials.

作者信息

Zhao Ji-Bo, Li Yuan-Li, Wang Ye-Ming, Teng Jin-Liang, Xia Deng-Yun, Zhao Jin-Shi, Li Fu-Long

机构信息

Department of Anesthesiology Department of Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China.

出版信息

Medicine (Baltimore). 2018 Feb;97(5):e9771. doi: 10.1097/MD.0000000000009771.

Abstract

BACKGROUND

This meta-analysis aimed to assess the efficiency and safety of intravenous infusion of lidocaine for pain management after laparoscopic cholecystectomy (LC).

METHODS

A systematic search was performed in PubMed (August 1966-2017), Medline (August 1966-2017), Embase (August 1980-2017), ScienceDirect (August 1985-2017), and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata.11.0 software.

RESULTS

A total of 5 RCTs were retrieved involving 274 patients. The present meta-analysis indicated that there were significant differences between groups in terms of visual analog scale scores at 12hours (weighted mean difference [WMD]=-0.743, 95% CI: -1.246 to -0.240, P = .004), 24hours (WMD=-0.712, 95% CI: -1.239 to -0.184, P = .008), and 48hours (WMD=-0.600, 95% CI: -0.972 to -0.229, P = .002) after LC. Significant differences were found regarding opioid consumption at 12hours (WMD=-3.136, 95% CI: -5.591 to -0.680, P = .012), 24hours (WMD=-4.739, 95% CI: -8.291 to -1.188, P = .009), and 48hours (WMD=-3.408, 95% CI: -5.489 to -1.326, P = .001) after LC.

CONCLUSION

Intravenous lidocaine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the lidocaine groups. Higher quality RCTs are still required for further research.

摘要

背景

本荟萃分析旨在评估腹腔镜胆囊切除术(LC)后静脉输注利多卡因进行疼痛管理的有效性和安全性。

方法

在PubMed(1966年8月 - 2017年)、Medline(1966年8月 - 2017年)、Embase(1980年8月 - 2017年)、ScienceDirect(1985年8月 - 2017年)和Cochrane图书馆进行系统检索。仅纳入随机对照试验(RCT)。根据I2统计量检验的异质性使用固定/随机效应模型。使用Stata.11.0软件进行荟萃分析。

结果

共检索到5项RCT,涉及274例患者。本荟萃分析表明,LC术后12小时(加权平均差[WMD]= - 0.743,95%CI: - 1.246至 - 0.240,P = 0.004)、24小时(WMD = - 0.712,95%CI: - 1.239至 - 0.184,P = 0.008)和48小时(WMD = - 0.600,95%CI: - 0.972至 - 0.229,P = 0.002)时,两组间视觉模拟量表评分存在显著差异。LC术后12小时(WMD = - 3.136,95%CI: - 5.591至 - 0.680,P = 0.012)、24小时(WMD = - 4.739,95%CI: - 8.291至 - 1.188,P = 0.009)和48小时(WMD = - 3.408,95%CI: - 5.489至 - 1.326,P = 0.001)时,阿片类药物消耗量存在显著差异。

结论

静脉输注利多卡因可显著降低LC术后的疼痛评分和阿片类药物消耗量。此外,利多卡因组的不良反应较少。仍需要更高质量的RCT进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6775/5805439/6280ebbc2b1f/medi-97-e9771-g001.jpg

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