曲马多在诊断性门诊宫腔镜检查中缓解疼痛的疗效和安全性：随机对照试验的系统评价和荟萃分析。

Efficacy and safety of tramadol in pain relief during diagnostic outpatient hysteroscopy: systematic review and meta-analysis of randomized controlled trials.

机构信息

Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt; Medical Research Education and Practice Association (MREP), Cairo, Egypt.

Medical Research Education and Practice Association (MREP), Cairo, Egypt; Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Fertil Steril. 2019 Mar;111(3):547-552. doi: 10.1016/j.fertnstert.2018.10.026. Epub 2019 Jan 30.

DOI:10.1016/j.fertnstert.2018.10.026

PMID:30711222

Abstract

OBJECTIVE

To evaluate the evidence about the safety and efficacy of tramadol in pain relief during diagnostic outpatient hysteroscopy (OH).

DESIGN

Systematic review and meta-analysis of randomized controlled trials.

SETTING

Not applicable.

PATIENT(S): Patients undergoing diagnostic OH received tramadol versus those who were administered placebo.

INTERVENTION(S): Electronic databases were searched using the following MeSH terms (tramadol OR opioids OR opioid OR narcotic OR narcotics) AND (hysteroscopy OR hysteroscopic).

MAIN OUTCOME MEASURE(S): Pain assessed by visual analogue scale (VAS) during OH, immediately and 30 minutes after the procedure.

RESULT(S): One hundred thirteen studies were identified of which four randomized clinical trials were deemed eligible for this review (tramadol: n = 209; placebo: n = 209). The pooled estimate showed that tramadol significantly reduced VAS during procedure than placebo (weighted mean difference [WMD] = -1.33; 95% confidence interval [CI] -1.78 to -0.88, I = 3%, P = .36). In addition, tramadol significantly reduced VAS immediately after the procedure (WMD = -1.05; 95% CI -1.49 to -0.61, I= 0, P = .84) and 30 minutes after (WMD = -0.98; 95% CI -1.30 to -0.65, I = 0, P = .88).

CONCLUSION(S): This meta-analysis suggests that tramadol is safe, effective, and gives favorable results in reducing pain during diagnostic OH.

摘要

目的

评估曲马多在诊断性门诊宫腔镜检查（OH）中缓解疼痛的安全性和有效性的证据。

设计

系统评价和随机对照试验的荟萃分析。

设置

不适用。

患者

接受诊断性 OH 的患者接受曲马多治疗，而接受安慰剂治疗的患者。

干预措施

使用以下 MeSH 术语（曲马多或阿片类药物或阿片类或麻醉性或麻醉剂）和（宫腔镜检查或宫腔镜检查）对电子数据库进行搜索。

主要观察指标

OH 过程中、手术即刻和 30 分钟后通过视觉模拟量表（VAS）评估的疼痛。

结果

共确定了 113 项研究，其中 4 项随机临床试验被认为符合本综述的纳入标准（曲马多：n = 209；安慰剂：n = 209）。汇总估计表明，曲马多与安慰剂相比，在手术过程中显著降低了 VAS（加权均数差 [WMD] = -1.33；95%置信区间 [CI] -1.78 至 -0.88，I = 3%，P =.36）。此外，曲马多在手术后即刻（WMD = -1.05；95% CI -1.49 至 -0.61，I = 0，P =.84）和 30 分钟后（WMD = -0.98；95% CI -1.30 至 -0.65，I = 0，P =.88）显著降低了 VAS。