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腹腔镜手术后羟考酮与其他阿片类镇痛药的比较:一项荟萃分析。

Oxycodone versus other opioid analgesics after laparoscopic surgery: a meta-analysis.

机构信息

Department of Anesthesiology, The People's Hospital of Jizhou District, Tianjin, 301900, Tianjin, China.

Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.

出版信息

Eur J Med Res. 2021 Jan 9;26(1):4. doi: 10.1186/s40001-020-00463-w.

Abstract

BACKGROUND

Intravenous opioids are administered for the management of visceral pain after laparoscopic surgery. Whether oxycodone has advantages over other opioids in the treatment of visceral pain is not yet clear.

METHODS

In this study, the analgesic efficiency and adverse events of oxycodone and other opioids, including alfentanil, sufentanil, fentanyl, and morphine, in treating post-laparoscopic surgery visceral pain were evaluated. This review was conducted according to the methodological standards described in the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. The PubMed, Embase, and Cochrane databases were searched in December 2019.

RESULTS

Ten studies were included in this review. The sample size was 695 participants. The results showed that compared with morphine and fentanyl, oxycodone had a more potent analgesic efficacy on the first day after laparoscopic surgery, especially during the first 0.5 h. There was no significant difference in sedation between the two groups. Compared to morphine and fentanyl, oxycodone was more likely to lead to dizziness and drowsiness. Overall, patient satisfaction did not differ significantly between oxycodone and other opioids.

CONCLUSIONS

Oxycodone is superior to other analgesics within 24 h after laparoscopic surgery, but its adverse effects should be carefully considered.

摘要

背景

腹腔镜手术后,静脉内给予阿片类药物用于内脏痛的管理。羟考酮在治疗内脏痛方面是否优于其他阿片类药物尚不清楚。

方法

本研究评估了羟考酮与其他阿片类药物(包括阿芬太尼、舒芬太尼、芬太尼和吗啡)在治疗腹腔镜术后内脏痛中的镇痛效果和不良反应。本综述按照《Cochrane 干预措施系统评价手册》和《系统评价和荟萃分析报告的首选条目》中描述的方法学标准进行。于 2019 年 12 月检索了 PubMed、Embase 和 Cochrane 数据库。

结果

本综述纳入了 10 项研究。样本量为 695 名参与者。结果表明,与吗啡和芬太尼相比,羟考酮在腹腔镜手术后的第一天(尤其是在最初 0.5 h 内)具有更强的镇痛效果。两组镇静效果无显著差异。与吗啡和芬太尼相比,羟考酮更有可能导致头晕和嗜睡。总体而言,羟考酮与其他阿片类药物相比,患者满意度无显著差异。

结论

羟考酮在腹腔镜手术后 24 h 内优于其他镇痛药,但应慎重考虑其不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbaf/7796650/e9dc8d91ffc6/40001_2020_463_Fig1_HTML.jpg

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