Department of Anesthesiology, Affiliated Hospital of Jining Medical University, Jining, China.
Department of Urology, Affiliated Hospital of Jining Medical University, Jining, China.
Pain Pract. 2022 Mar;22(3):405-413. doi: 10.1111/papr.13092. Epub 2021 Dec 2.
Acetaminophen is a widely clinically used analgesic. However, the clinical effect of the route of administration on postoperative analgesia as well as on postoperative nausea and vomiting in patients undergoing general anesthesia remains unclear. This study aimed to explore whether the route of administration of acetaminophen affects postoperative analgesia, nausea, and vomiting in patients undergoing general anesthesia.
We included all randomized controlled trials investigating the effects of the route of administration of acetaminophen on postoperative pain, nausea, and vomiting in patients undergoing general anesthesia. Independent examiners reviewed the literature and extracted data, with disagreements resolved through negotiation or the involvement of a third party. The Cochrane risk assessment tool was used to evaluate the quality of the included randomized controlled trials. A narrative synthesis was conducted to summarize the qualitative information from the included studies. A meta-integration of quantitative data was performed using RevMan 5.4.
Ten studies met the inclusion criteria. Eight studies assessed postoperative pain, whereas two assessed postoperative nausea and vomiting. Data from the eight studies assessing postoperative pain confirmed that there was no difference between intravenously and orally administered acetaminophen in adults (OR = -0.13; 95% CI, -0.36 to 0.11; p = 0.3). Data from the two studies assessing postoperative nausea and vomiting revealed no difference between intravenously and orally administered acetaminophen in adults (OR = 0.89; 95% CI, 0.64-1.25; p = 0.51). The included studies were of poor quality, with a heterogeneity of 68%.
No differences in postoperative analgesia or postoperative nausea and vomiting were observed between the routes of administration (intravenous vs. oral) of acetaminophen in adult patients undergoing general anesthesia. There is a need for future large sample studies to increase the reliability of the results.
对乙酰氨基酚是一种广泛应用于临床的镇痛药。然而，其给药途径对全麻术后患者的镇痛效果以及恶心呕吐的影响尚不清楚。本研究旨在探讨对乙酰氨基酚的给药途径是否影响全麻术后患者的镇痛、恶心和呕吐。
我们纳入了所有研究对乙酰氨基酚给药途径对全麻术后疼痛、恶心和呕吐影响的随机对照试验。独立的审查员对文献进行了回顾和数据提取，存在分歧时通过协商或第三方介入解决。采用 Cochrane 风险评估工具评估纳入的随机对照试验的质量。采用叙述性综合法对纳入研究的定性信息进行总结。使用 RevMan 5.4 对定量数据进行荟萃整合。
符合纳入标准的研究有 10 项。其中 8 项评估了术后疼痛，2 项评估了术后恶心和呕吐。8 项评估术后疼痛的研究数据表明，成人静脉和口服给予对乙酰氨基酚在术后疼痛方面无差异（OR=-0.13；95%CI，-0.36 至 0.11；p=0.3）。2 项评估术后恶心和呕吐的研究数据表明，成人静脉和口服给予对乙酰氨基酚在术后恶心和呕吐方面无差异（OR=0.89；95%CI，0.64-1.25；p=0.51）。纳入的研究质量较差，异质性为 68%。
在全麻患者中，对乙酰氨基酚的给药途径（静脉与口服）在术后镇痛或术后恶心呕吐方面无差异。需要进一步开展大样本量的研究以提高结果的可靠性。
