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经阴道子宫切除术的预防性局部镇痛：系统评价。

Preemptive local analgesia at vaginal hysterectomy: a systematic review.

机构信息

Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.

Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.

出版信息

Int Urogynecol J. 2022 Sep;33(9):2357-2366. doi: 10.1007/s00192-021-04999-1. Epub 2021 Dec 6.

DOI:10.1007/s00192-021-04999-1
PMID:34870713
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9427873/
Abstract

INTRODUCTION AND HYPOTHESIS

We conducted a systematic review of the effectiveness of local preemptive analgesia for postoperative pain control in women undergoing vaginal hysterectomy.

METHODS

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched systematically to identify eligible studies published through September 25, 2019. Only randomized controlled trials and systematic reviews addressing local preemptive analgesia compared to placebo at vaginal hysterectomy were considered. Data were extracted by two independent reviewers. Results were compared, and disagreement was resolved by discussion. Forty-seven studies met inclusion criteria for full-text review. Four RCTs, including a total of 197 patients, and two SRs were included in the review.

RESULTS

Preemptive local analgesia reduced postoperative pain scores up to 6 h and postoperative opioid requirements in the first 24 h after surgery.

CONCLUSION

Preemptive local analgesia at vaginal hysterectomy results in less postoperative pain and less postoperative opioid consumption.

摘要

简介和假设

我们对局部预防性镇痛在阴道子宫切除术患者术后疼痛控制中的有效性进行了系统评价。

方法

系统检索了 MEDLINE、EMBASE、Cochrane 对照试验中心注册库和 Cochrane 系统评价数据库，以确定截至 2019 年 9 月 25 日发表的合格研究。仅考虑了比较局部预防性镇痛与安慰剂在阴道子宫切除术中应用的随机对照试验和系统评价。由两名独立评审员提取数据。对结果进行比较，并通过讨论解决分歧。47 项研究符合全文审查标准。综述纳入了 4 项 RCT（共 197 名患者）和 2 项 SR。

结果

预防性局部镇痛可降低术后 6 小时内的疼痛评分和术后 24 小时内的阿片类药物需求。

结论

阴道子宫切除术中的预防性局部镇痛可减少术后疼痛和术后阿片类药物的消耗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b601/9427873/b72111ed220b/192_2021_4999_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b601/9427873/b72111ed220b/192_2021_4999_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b601/9427873/b72111ed220b/192_2021_4999_Fig1_HTML.jpg

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Gynecol Oncol. 2021 Feb;160(2):464-468. doi: 10.1016/j.ygyno.2020.11.024. Epub 2020 Dec 6.
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Safety and Feasibility of Discharge Without an Opioid Prescription for Patients Undergoing Gynecologic Surgery.妇科手术后患者无阿片类药物处方出院的安全性和可行性。
Obstet Gynecol. 2020 Dec;136(6):1126-1134. doi: 10.1097/AOG.0000000000004158.
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Is the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia?
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Reg Anesth Pain Med. 2020 Dec;45(12):1000-1005. doi: 10.1136/rapm-2020-101670. Epub 2020 Sep 7.
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