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静脉注射对乙酰氨基酚在全膝关节置换术后多模式镇痛管理中的疗效：一项荟萃分析

Efficacy of intravenous acetaminophen in multimodal management for pain relief following total knee arthroplasty: a meta-analysis.

作者信息

Shi Song-Bo, Wang Xing-Bo, Song Jian-Min, Guo Shi-Fang, Chen Zhi-Xin, Wang Yin

机构信息

Orthopaedics Department, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China.

出版信息

J Orthop Surg Res. 2018 Oct 11;13(1):250. doi: 10.1186/s13018-018-0950-7.

DOI:10.1186/s13018-018-0950-7
PMID:30305124
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6180443/
Abstract

BACKGROUND

The efficacy of intravenous acetaminophen in multimodal pain management in patients undergoing total knee arthroplasty (TKA) is controversial. The purpose of this meta-analysis was to compare the efficacy of intravenous acetaminophen versus placebo in TKA.

METHODS

Randomized controlled trials (RCTs) or retrospective cohort studies (RCSs) concerning related topics were retrieved from PubMed (1996-June 2018), Embase (1980-June 2018), and the Cochrane Library (CENTRAL June 2018). Any studies comparing intravenous acetaminophen with a placebo were included in this meta-analysis. Meta-analysis results were collected and analyzed by Stata 12.0. Subgroup analysis was performed according to the general characteristics of the patients.

RESULTS

In total, the patients from six studies met the inclusion criteria. Our meta-analysis results indicated that compared with a control group, intravenous acetaminophen was associated with reductions in total morphine consumption and visual analogue scale (VAS) score at postoperative day (POD) 3. However, there was no significant difference in morphine consumption at POD 1 or in VAS at POD 1 or POD 2. Moreover, there was no significant difference in the length of hospital stay.

CONCLUSIONS

Based on our results, intravenous acetaminophen in multimodal management has shown better efficacy in pain relief at POD 3 and has morphine-sparing effects. High-quality studies with more patients are needed in the future.

摘要

背景

静脉注射对乙酰氨基酚在全膝关节置换术（TKA）患者多模式疼痛管理中的疗效存在争议。本荟萃分析的目的是比较静脉注射对乙酰氨基酚与安慰剂在TKA中的疗效。

方法

从PubMed（1996年 - 2018年6月）、Embase（1980年 - 2018年6月）和Cochrane图书馆（2018年6月CENTRAL）检索有关相关主题的随机对照试验（RCT）或回顾性队列研究（RCS）。本荟萃分析纳入任何比较静脉注射对乙酰氨基酚与安慰剂的研究。使用Stata 12.0收集和分析荟萃分析结果。根据患者的一般特征进行亚组分析。

结果

共有六项研究的患者符合纳入标准。我们的荟萃分析结果表明，与对照组相比，静脉注射对乙酰氨基酚与术后第3天（POD 3）的吗啡总消耗量和视觉模拟量表（VAS）评分降低相关。然而，在POD 1时的吗啡消耗量或在POD 1或POD 2时的VAS评分方面没有显著差异。此外，住院时间也没有显著差异。

结论

根据我们的结果，多模式管理中静脉注射对乙酰氨基酚在POD 3时的疼痛缓解方面显示出更好的疗效，并具有节省吗啡的作用。未来需要更多患者参与的高质量研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/8b0d1d882efa/13018_2018_950_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/60a32bb73ca8/13018_2018_950_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/7fe9be00248e/13018_2018_950_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/ab94b2239e53/13018_2018_950_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/4a867c792587/13018_2018_950_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/416580172e1d/13018_2018_950_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/6fcaefdfffb5/13018_2018_950_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/b6356cf9ad40/13018_2018_950_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/8b0d1d882efa/13018_2018_950_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/60a32bb73ca8/13018_2018_950_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/7fe9be00248e/13018_2018_950_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/ab94b2239e53/13018_2018_950_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/4a867c792587/13018_2018_950_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/416580172e1d/13018_2018_950_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/6fcaefdfffb5/13018_2018_950_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/b6356cf9ad40/13018_2018_950_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc7/6180443/8b0d1d882efa/13018_2018_950_Fig8_HTML.jpg

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