Harle Christopher A, Danielson Elizabeth C, Derman Wayne, Stuart Mark, Dvorak Jiri, Smith Lisa, Hainline Brian
Department of Health Policy and Management, Indiana University, Indianapolis, Indiana.
Institute of Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa.
Clin J Sport Med. 2018 Sep;28(5):417-426. doi: 10.1097/JSM.0000000000000604.
To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes.
Systematic literature review.
Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus.
Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded.
Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared.
Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.
确定精英运动员使用的镇痛疼痛管理策略的患病率、使用频率及效果。
系统文献综述。
六个数据库：Ovid/Medline、SPORTDiscus、CINAHL、Embase、Cochrane图书馆和Scopus。
涉及精英运动员且聚焦于用于疼痛或疼痛性损伤的药物使用或效果的实证研究。排除涉及业余运动员或进行一般锻炼者的研究。
在检索到的70篇文章中，大多数研究了精英运动员使用止痛药物的频率，包括非甾体抗炎药（NSAIDs）、皮质类固醇、麻醉剂和阿片类药物。一小部分研究评估了药物对疼痛、功能和不良反应等结果的影响。据报道，口服NSAIDs是最常用的药物，在一些国际体育赛事中，超过50%的运动员使用该药物。研究止痛药物对精英运动员影响的研究通常样本量较小，且缺乏与接受治疗的运动员进行比较的对照组。
现有实证研究没有提供足够的证据来指导运动员和医疗保健专业人员做出止痛药物治疗决策。基于关于NSAIDs广泛使用的相对确凿证据，临床医生和政策制定者应仔细评估他们目前对NSAIDs使用的建议，并坚持采用更统一的基于共识的策略对精英运动员进行多学科疼痛管理。未来，我们希望看到更多关于精英运动员各种疼痛管理策略的严格前瞻性研究，从而实现从基于共识的建议向基于证据的建议的转变。
