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帕瑞昔布用于全膝关节置换术后减少疼痛和阿片类药物消耗的疗效和安全性:一项随机对照试验的荟萃分析。

The efficacy and safety of parecoxib for reducing pain and opioid consumption following total knee arthroplasty: A meta-analysis of randomized controlled trials.

机构信息

Department of Orthopedics, Jiangyin Hospital Affiliated to Southeast University, Wuxi, 214400, China.

Department of Orthopedics, Jiangyin Hospital Affiliated to Southeast University, Wuxi, 214400, China.

出版信息

Int J Surg. 2018 Nov;59:67-74. doi: 10.1016/j.ijsu.2018.09.017. Epub 2018 Oct 4.

Abstract

BACKGROUND

The goal of the current meta-analysis is to make a credible and overall assessment about the efficacy and safety of parenteral parecoxib for pain control in total knee arthroplasty (TKA).

METHODS

The following online electronic databases, such as PubMed, Cochrane, Embase, were searched to identify the qualified studies updated to August 2018 according to the index words. Weight mean difference (WMD) or risk difference (RD) along with 95% confidence interval (CI) was utilized to analyze the main outcomes. To assess the heterogeneity of study trial and determine the model for analysis (random-effect model or fixed-effect model), I tests and Chi-squared were conducted. We utilized the STATA 10.0 (TX, USA) to perform all statistical analyses.

RESULT

Totally, four studies were involved in the meta-analysis with 418 patients. The present meta-analysis indicated that intravenous parecoxib was associated with a significantly improved pain relief and opioid consumption after TKA. There was no increased risk of adverse effects related to parecoxib.

CONCLUSION

Intravenous parecoxib is effective in reducing knee pain and opioid consumption in patient with TKA. Further well-designed research with large simple sizes is necessary to confirm our conclusion.

摘要

背景

本荟萃分析的目的是对关节置换术后(TKA)使用帕瑞昔布钠进行疼痛控制的疗效和安全性进行可信和全面的评估。

方法

根据索引词,检索以下在线电子数据库,如 PubMed、Cochrane、Embase 等,以确定截至 2018 年 8 月的合格研究。使用加权均数差(WMD)或风险差(RD)及 95%置信区间(CI)分析主要结局。使用 I 检验和 Chi-squared 检验评估研究试验的异质性,并确定分析模型(随机效应模型或固定效应模型)。使用 STATA 10.0(美国德克萨斯州)进行所有统计分析。

结果

荟萃分析共纳入四项研究,涉及 418 例患者。本荟萃分析表明,静脉注射帕瑞昔布钠可显著减轻 TKA 后的疼痛和阿片类药物的使用。帕瑞昔布钠相关不良反应的风险没有增加。

结论

静脉注射帕瑞昔布钠可有效减轻 TKA 患者的膝关节疼痛和阿片类药物的使用。需要进一步进行设计良好、样本量大的研究来证实我们的结论。

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