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腰椎手术围手术期使用非甾体类抗炎药进行超前镇痛的疗效和安全性：一项系统评价和荟萃分析

Efficacy and safety of perioperative use of non-steroidal anti-inflammatory drugs for preemptive analgesia in lumbar spine surgery: a systematic review and meta-analysis.

作者信息

Ma Nanshan, Yi Ping, Xiong Zhencheng, Ma Haoning, Tan Mingsheng, Tang Xiangsheng

机构信息

Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.

Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China.

出版信息

Perioper Med (Lond). 2023 Nov 23;12(1):61. doi: 10.1186/s13741-023-00347-7.

DOI:10.1186/s13741-023-00347-7
PMID:37996936
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10668431/
Abstract

OBJECTIVE: Lumbar spine disorders have become an increasingly common health problem in recent years. Modern clinical studies have shown that perioperative analgesia at certain doses can reduce postoperative pain by inhibiting the process of peripheral sensitization and central sensitization, which is also known as "preemptive analgesia," Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that achieve antipyretic and analgesic effects by inhibiting cyclooxygenase (COX) and affecting the production of prostaglandins. Our meta-analysis aimed to assess the efficacy and safety of perioperative preemptive analgesia with non-steroidal anti-inflammatory drugs in patients with lumbar spine surgery. METHODS: We searched PubMed, ScienceDirect, the Cochrane Library, and the Web of Science for randomized controlled trials (RCTs) that met the inclusion criteria. A total of 12 clinical studies were included to assess the efficacy and safety of perioperative NSAIDs preemptive analgesia for lumbar spine surgery. RESULT: Twelve studies, including 845 patients, met the inclusion criteria. The results showed that perioperative receipt of NSAIDs for preemptive analgesia was effective and safe. Patient's postoperative morphine consumption (P < 0.05), visual analog scale (P < 0.05), and numerical rating scale (P < 0.05) were not statistically associated with postoperative complications (P > 0.05). CONCLUSION: Our findings suggest that NSAIDs are effective and safe for preemptive analgesia in the perioperative period of lumbar spine surgery and that more and better quality RCTs and more in-depth studies of pain mechanics are still needed.

摘要

目的：近年来，腰椎疾病已成为日益常见的健康问题。现代临床研究表明，一定剂量的围手术期镇痛可通过抑制外周敏化和中枢敏化过程来减轻术后疼痛，这也被称为“超前镇痛”。非甾体抗炎药（NSAIDs）是一类通过抑制环氧化酶（COX）并影响前列腺素生成来实现解热和镇痛作用的药物。我们的荟萃分析旨在评估非甾体抗炎药用于腰椎手术患者围手术期超前镇痛的疗效和安全性。 方法：我们在PubMed、ScienceDirect、Cochrane图书馆和Web of Science中检索符合纳入标准的随机对照试验（RCTs）。共纳入12项临床研究，以评估围手术期非甾体抗炎药超前镇痛用于腰椎手术的疗效和安全性。 结果：12项研究（包括845例患者）符合纳入标准。结果表明，围手术期使用非甾体抗炎药进行超前镇痛是有效且安全的。患者术后吗啡用量（P < 0.05）、视觉模拟评分（P < 0.05）和数字评分量表（P < 0.05）与术后并发症无统计学关联（P > 0.05）。 结论：我们的研究结果表明，非甾体抗炎药在腰椎手术围手术期用于超前镇痛是有效且安全的，仍需要更多、质量更高的随机对照试验以及对疼痛机制进行更深入的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/e9eca833ff50/13741_2023_347_Fig9_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/c799362a59bc/13741_2023_347_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/74627aba1746/13741_2023_347_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/ec3e84792ff1/13741_2023_347_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/065c29844d73/13741_2023_347_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/e9eca833ff50/13741_2023_347_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/dfa3cf647633/13741_2023_347_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/be7296c5b727/13741_2023_347_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/07579e3b5862/13741_2023_347_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/50d2bf8e0ffb/13741_2023_347_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/c799362a59bc/13741_2023_347_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/74627aba1746/13741_2023_347_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/ec3e84792ff1/13741_2023_347_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/065c29844d73/13741_2023_347_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b0e/10668431/e9eca833ff50/13741_2023_347_Fig9_HTML.jpg

相似文献

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Efficacy and safety of perioperative use of non-steroidal anti-inflammatory drugs for preemptive analgesia in lumbar spine surgery: a systematic review and meta-analysis.

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[3]
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引用本文的文献

[1]
Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review.

Pharmacy (Basel). 2025-2-4

[2]
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[3]
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Pain Ther. 2024-12

[4]
Preoperative versus postoperative nonsteroidal anti-inflammatory drugs in femoroacetabular impingement patients undergoing hip arthroscopy surgery: analgesic effect, joint function, patients' satisfaction, and quality of life.

Inflammopharmacology. 2024-12

本文引用的文献

[1]
VAS and NRS, Same or Different? Are Visual Analog Scale Values and Numerical Rating Scale Equally Viable Tools for Assessing Patients after Microdiscectomy?

Pain Res Manag. 2022

[2]
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Curr Pain Headache Rep. 2020-2-18

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Acute postoperative pain management.

Br J Surg. 2020-1

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[The role of multimodal postoperative analgesia after primary hip arthroplasty].

Orv Hetil. 2019-12

[5]
Preemptive analgesia after lumbar spine surgery by pregabalin and celecoxib: a prospective study.

Drug Des Devel Ther. 2019-7-3

[6]
Enhanced recovery after surgery (ERAS) program for lumbar spine fusion.

Perioper Med (Lond). 2019-5-28

[7]
A prospective randomized study to analyze the efficacy of balanced pre-emptive analgesia in spine surgery.

Spine J. 2018-10-22

[8]
Benefit versus Severe Side Effects of Opioid Analgesia: Novel Utility Functions of Probability of Analgesia and Respiratory Depression.

Anesthesiology. 2018-5

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Neuroinflammation and Central Sensitization in Chronic and Widespread Pain.

Anesthesiology. 2018-8

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