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局部伤口浸润用于开放性肝切除术以减轻伤口疼痛:系统评价和荟萃分析。

Use of local wound infiltration in open hepatectomy to reduce wound pain: A systematic review and meta-analysis.

机构信息

Department of Anesthesiology, Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.

出版信息

Int Wound J. 2023 Nov;20(9):3760-3767. doi: 10.1111/iwj.14271. Epub 2023 Jun 7.

Abstract

The aim of this study was to assess the effects of local wound infiltration anaesthesia on postoperative wound pain in patients undergoing open liver resection. The Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM) and Wanfang databases were searched. The search period spanned from database creation to December 2022. All relevant studies on local wound infiltration anaesthesia for analgesia after hepatectomy were included. Two investigators independently screened the literature, extracted data and evaluated the quality of each study. Review Manager (RevMan) 5.4 software (Cochrane Collaboration) was used for the meta-analysis, in which 12 studies with 986 patients were included. The results show that local wound infiltration anaesthesia effectively reduced surgical site wound pain at 4 h (mean difference [MD]: -1.26, 95% confidence intervals [CIs]: -2.15 to -0.37, P = .005), 12 h (MD: -0.84, 95% CIs: -1.26 to -0.42, P < .001), 24 h (MD: -0.57, 95% CIs: -1.01 to -0.14, P = .009) and 48 h (MD: -0.54, 95% CIs: -0.81 to -0.26, P < .001) postoperatively; however, there was no significant difference in analgesia at 72 h postoperatively (MD: -0.10, 95% CIs: -0.80 to 0.59, P = .77). These findings suggest that local wound infiltration anaesthesia administered to patients undergoing open liver resection provides good postoperative wound analgesia at the surgical site.

摘要

本研究旨在评估局部伤口浸润麻醉对接受开腹肝切除术患者术后伤口疼痛的影响。我们检索了 Cochrane 图书馆、PubMed、EMBASE、中国国家知识基础设施 (CNKI)、中国生物医学文献数据库 (CBM) 和万方数据库。检索时间从数据库创建到 2022 年 12 月。纳入所有关于肝切除术后局部伤口浸润麻醉镇痛的相关研究。两名研究者独立筛选文献、提取数据并评估每项研究的质量。使用 Review Manager (RevMan) 5.4 软件 (Cochrane 协作网) 进行荟萃分析,其中纳入了 12 项研究,共 986 名患者。结果显示,局部伤口浸润麻醉能有效减轻术后 4 h(MD:-1.26,95%CI:-2.15 至-0.37,P=0.005)、12 h(MD:-0.84,95%CI:-1.26 至-0.42,P<0.001)、24 h(MD:-0.57,95%CI:-1.01 至-0.14,P=0.009)和 48 h(MD:-0.54,95%CI:-0.81 至-0.26,P<0.001)的手术部位伤口疼痛;然而,术后 72 h 的镇痛效果差异无统计学意义(MD:-0.10,95%CI:-0.80 至 0.59,P=0.77)。这些发现表明,局部伤口浸润麻醉应用于接受开腹肝切除术的患者,可提供良好的术后手术部位伤口镇痛效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ef/10588336/7688988f6f7f/IWJ-20-3760-g007.jpg

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