Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana.
Department of Biostatics, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
JSLS. 2022 Jul-Sep;26(3). doi: 10.4293/JSLS.2022.00032.
To perform a systematic review and meta-analysis to evaluate the efficacy of perioperative acetazolamide (ACTZ) administration with laparoscopy for reducing postoperative referred pain.
The following databases were searched from inception to March 1, 2020: Cochrane, PubMed, PubMed Central, Ovid, and Embase. Electronic search used: Acetazolamide AND (laparoscopy OR laparoscopic OR Celioscopy OR Celioscopies OR Peritoneoscopy OR Peritoneoscopies). No limits or filters were used. We included only studies of patients who underwent abdominal laparoscopy (LSC), had a pain assessment at approximately 24 hours postoperatively, and included a treatment with ACTZ group and a no-treatment or minimal-treatment comparison group.
Five studies met inclusion criteria, with a combined total of 253 participants, 116 in the ACTZ group and 137 in the control group. A Bayesian hierarchical model was assumed for the study specific treatment effects. Posterior sampling was conducted via Markov Chain Monte Carlo methods, and posterior inference carried out on the hierarchical treatment effect. ACTZ significantly decreased average pain scores compared to control group by -0.726 points (95% confidence interval -1.175-0.264). The posterior probability that ACTZ decreases mean pain scores by ≥ 0.5 was 0.846.
Current available evidence demonstrates that perioperative ACTZ may provide a modest improvement in postoperative referred pain following LSC.
进行系统评价和荟萃分析，评估围手术期乙酰唑胺（ACTZ）给药联合腹腔镜用于减少术后牵涉痛的疗效。
从建库到 2020 年 3 月 1 日，检索以下数据库：Cochrane、PubMed、PubMed Central、Ovid 和 Embase。电子检索使用：Acetazolamide AND (laparoscopy OR laparoscopic OR Celioscopy OR Celioscopies OR Peritoneoscopy OR Peritoneoscopies)。未使用任何限制或筛选条件。我们仅纳入接受腹部腹腔镜手术（LSC）、术后约 24 小时进行疼痛评估且包含 ACTZ 治疗组和无治疗或最小治疗对照组的患者的研究。
符合纳入标准的 5 项研究共纳入 253 名患者，ACTZ 组 116 例，对照组 137 例。假设采用贝叶斯层次模型进行研究特定的治疗效果分析。通过马尔可夫链蒙特卡罗方法进行后验抽样，并在后验推断中进行层次治疗效果分析。与对照组相比，ACTZ 组的平均疼痛评分显著降低了 -0.726 分（95%置信区间 -1.175-0.264）。ACTZ 降低平均疼痛评分≥0.5 的后验概率为 0.846。
目前的证据表明，围手术期使用 ACTZ 可能会对 LSC 术后牵涉痛的发生产生适度改善。
