Department of Anesthesiology, Shaoxing Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Shaoxing, China.
Department of Anesthesiology, Shaoxing Shangyu Second People's Hospital, Shaoxing, China.
Sci Rep. 2021 Sep 13;11(1):18104. doi: 10.1038/s41598-021-96546-7.
The aim of this study was to assess the analgesic efficacy of QLB versus controls in women undergoing cesarean section (CS). We systematically searched Cochrane Library, PUBMED, EMBASE, VIP, WANFANG, and China National Knowledge Infrastructure. Trials were eligible if parturients received QLB during CS. GRADE system was used to assess the certainty of evidence and Trial sequential analyses (TSA) were performed to determine whether the results are supported by sufficient data. Thirteen studies involving 1269 patients were included. Compared to controls, QLB significantly reduced the cumulative postoperative intravenous opioid consumption (in milligram morphine equivalents) at 24 h (MD, - 11.51 mg; 95% CI - 17.05 to - 5.96) and 48 h (MD, - 15.87 mg; 95% CI - 26.36 to - 5.38), supported by sufficient data confirmed by TSA. The postoperative pain scores were significantly reduced by QLB at 4 h, 6 h, 12 h, 24 h, and 48 h postoperatively by QLB compared with control. Moreover, the time to first request for rescue analgesic and the incidence of PONV were also significantly reduced by QLB. The quality of evidence of most results were low and moderate assessed by GRADE.
本研究旨在评估 QLB 与对照组在剖宫产产妇中的镇痛效果。我们系统地检索了 Cochrane 图书馆、PUBMED、EMBASE、VIP、WANFANG 和中国国家知识基础设施。如果产妇在剖宫产期间接受 QLB，则试验符合条件。使用 GRADE 系统评估证据的确定性，并进行试验序贯分析（TSA），以确定结果是否有足够的数据支持。纳入了 13 项涉及 1269 名患者的研究。与对照组相比，QLB 显著减少了 24 小时（MD，-11.51mg；95%CI-17.05 至-5.96）和 48 小时（MD，-15.87mg；95%CI-26.36 至-5.38）的累积术后静脉阿片类药物消耗（以吗啡等效毫克计），这一结果由 TSA 证实有足够的数据支持。QLB 还显著降低了术后 4 小时、6 小时、12 小时、24 小时和 48 小时的术后疼痛评分。此外，QLB 还显著减少了首次要求解救性镇痛的时间和 PONV 的发生率。大多数结果的证据质量由 GRADE 评估为低和中。
