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术后口服镇痛药对儿童和青少年牙科治疗后额外缓解疼痛的效果和成本效益:包括系统评价的健康技术评估。

Effects and cost-effectiveness of postoperative oral analgesics for additional postoperative pain relief in children and adolescents undergoing dental treatment: Health technology assessment including a systematic review.

机构信息

Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.

Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden.

出版信息

PLoS One. 2019 Dec 31;14(12):e0227027. doi: 10.1371/journal.pone.0227027. eCollection 2019.

Abstract

BACKGROUND

There is an uncertainty regarding how to optimally prevent and/or reduce pain after dental treatment on children and adolescents.

AIM

To conduct a systematic review (SR) and health technology assessment (HTA) of oral analgesics administered after dental treatment to prevent postoperative pain in children and adolescents aged 3-19 years.

DESIGN

A PICO-protocol was constructed and registered in PROSPERO (CRD42017075589). Searches were conducted in PubMed, Cochrane, Scopus, Cinahl, and EMBASE, November 2018. The researchers (reading in pairs) assessed identified studies independently, according to the defined inclusion and exclusion criteria, following the PRISMA-statement.

RESULTS

3,963 scientific papers were identified, whereof 216 read in full text. None met the inclusion criteria, leading to an empty SR. Ethical issues were identified related to the recognized knowledge gap in terms of challenges to conduct studies that are well-designed from methodological as well as ethical perspectives.

CONCLUSIONS

There is no scientific support for the use or rejection of oral analgesics administered after dental treatment in order to prevent or reduce postoperative pain in children and adolescents. Thus, no guidelines can be formulated on this issue based solely on scientific evidence. Well-designed studies on how to prevent pain from developing after dental treatment in children and adolescents is urgently needed.

摘要

背景

对于如何优化儿童和青少年牙科治疗后的疼痛预防和/或减轻,目前仍存在不确定性。

目的

对牙科治疗后给予的口服镇痛药进行系统评价 (SR) 和卫生技术评估 (HTA),以预防 3-19 岁儿童和青少年的术后疼痛。

设计

制定了一个 PICO 方案,并在 PROSPERO(CRD42017075589)中进行了注册。2018 年 11 月,在 PubMed、Cochrane、Scopus、Cinahl 和 EMBASE 中进行了检索。研究人员(成对阅读)根据定义的纳入和排除标准,按照 PRISMA 声明独立评估确定的研究。

结果

共确定了 3963 篇科学论文,其中 216 篇全文阅读。没有一项符合纳入标准,导致 SR 为空。从方法学和伦理学的角度来看,在设计能够很好地从方法学和伦理学角度进行研究方面存在挑战,这方面的知识差距导致了伦理问题的出现。

结论

没有科学证据支持牙科治疗后使用或拒绝使用口服镇痛药来预防或减轻儿童和青少年的术后疼痛。因此,不能仅基于科学证据就该问题制定指南。迫切需要设计良好的研究来预防儿童和青少年牙科治疗后疼痛的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a87/6938383/64746081fae1/pone.0227027.g001.jpg

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