Zhang An-Mei, Chen Min, Tang Tai-Chun, Qin Di, Yue Ling, Zheng Hui
The 3rd Teaching Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine.
Hospital of Chengdu University of Traditional Chinese Medicine, China.
Medicine (Baltimore). 2019 Feb;98(6):e14441. doi: 10.1097/MD.0000000000014441.
Pain after hemorrhoidal surgery bothers both clinicians and patients. Somatosensory stimulation treatments have shown promising effect on the pain after hemorrhoidal surgery, but the comparative effectiveness between them has not been studied. We aim to determine the relative effectiveness among these treatments on pain relief after hemorrhoidal surgery by using network meta-analysis.
We will search the following electronic databases: MEDLINE, EMBASE, the Cochrane library, Chinese Biomedicine database (CBM), China National Knowledge Infrastructure (CNKI). We will include randomized controlled trials (RCTs) that examine the effect of somatosensory stimulation treatments on pain after hemorrhoidal surgery. The primary outcome will be the responder rate after treatment. The secondary outcomes will include the assessments with pain intensity scales (visual analog scale, numeric rating scale, or other scales) on day 1 to 7 after surgery. Two independent reviewers will extract needed information from eligible trials using standardized electronic forms. Network meta-analysis will be performed using a frequentist framework based on electrical network theory. The relative effectiveness of the treatments will be ranked by using P score, which is the mean probability of a treatment ranking the best in all treatments. Meta-regression will be performed to assess the impact of surgery type, anesthesia methods, and funding source on the treatment ranking. The quality of the eligible RCTs will be evaluated by the Cochrane risk of bias tool.
The result of this network meta-analysis will clarify which is the relatively best somatosensory-stimulation treatment in relieving postoperative pain caused by hemorrhoidal surgery, and the review will, therefore, guide the management of postoperative pain after hemorrhoidal surgery for clinicians and patients. This review does not require ethical approval and will be reported in a peer-reviewed journal.
PROSPERO CRD42018115558.
痔疮手术后的疼痛困扰着临床医生和患者。体感刺激疗法已显示出对痔疮手术后疼痛有显著效果，但尚未对它们之间的相对疗效进行研究。我们旨在通过网络荟萃分析确定这些疗法在缓解痔疮手术后疼痛方面的相对疗效。
我们将检索以下电子数据库：MEDLINE、EMBASE、Cochrane图书馆、中国生物医学数据库（CBM）、中国知网（CNKI）。我们将纳入考察体感刺激疗法对痔疮手术后疼痛影响的随机对照试验（RCT）。主要结局将是治疗后的缓解率。次要结局将包括术后第1至7天使用疼痛强度量表（视觉模拟量表、数字评定量表或其他量表）进行的评估。两名独立的评审员将使用标准化电子表格从符合条件的试验中提取所需信息。将使用基于电网理论的频率学派框架进行网络荟萃分析。治疗的相对疗效将使用P值进行排序，P值是一种治疗在所有治疗中排名最佳的平均概率。将进行Meta回归以评估手术类型、麻醉方法和资金来源对治疗排名的影响。符合条件的RCT的质量将通过Cochrane偏倚风险工具进行评估。
本网络荟萃分析的结果将阐明哪种体感刺激疗法在缓解痔疮手术引起的术后疼痛方面相对最佳，因此，该综述将为临床医生和患者指导痔疮手术后的疼痛管理。本综述无需伦理批准，并将在同行评审期刊上发表。
PROSPERO CRD42018115558。
