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静脉非阿片类镇痛药在髋关节手术后患者的术后疼痛管理中的有效性:系统评价和荟萃分析。

Effectiveness of Intravenous Non-Opioid Analgesics for Postoperative Pain Management of in Patients Undergoing Hip Surgery: A Systematic Review and Meta-Analysis.

机构信息

Department of Orthopedic Surgery, National Police Hospital, Seoul 05715, Republic of Korea.

Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.

出版信息

Medicina (Kaunas). 2023 Oct 27;59(11):1904. doi: 10.3390/medicina59111904.

Abstract

: Intravenous (IV) non-opioid analgesics (NOAs) have been extensively investigated as a multimodal analgesic strategy for the management of acute pain after hip surgery. This pair-wise meta-analysis examined IV NOA effects following hip surgery. : A systematic search of the MEDLINE (PUBMED), Embase, and Cochrane Library databases was performed for studies investigating the effect of IV NOA for postoperative pain management following hip surgery up to 7 June 2023. We compared in-admission opioid use, postoperative VAS (visual analogue scale) score, hospital stay duration, and opioid-related adverse events between IV NOA and control groups. : Seven studies were included with a total of 953 patients who underwent hip surgery. Of these, 478 underwent IV NOA treatment, and 475 did not. The IV NOA groups had lower opioid use within 24-h following hip surgery (SMD, -0.48; 95% CI, -0.66 to -0.30; < 0.01), lower VAS score (SMD, -0.47; 95% CI, -0.79 to -0.16; < 0.01), shorter hospital stay (SMD, -0.28; 95% CI, -0.44 to -0.12; < 0.01), and lower incidence of nausea and vomiting (OR, 0.32; 95% CI, 0.15 to 0.67; < 0.01) compared with the control groups. This meta-analysis demonstrated that IV NOA administration following hip surgery may have more favorable postoperative outcomes than those in control groups.

摘要

静脉内(IV)非阿片类镇痛药(NOA)已被广泛研究作为髋部手术后急性疼痛的多模式镇痛策略。本项成对荟萃分析检查了髋部手术后 IV NOA 的效果。

系统检索了 MEDLINE(PUBMED)、Embase 和 Cochrane 图书馆数据库,以查找截至 2023 年 6 月 7 日调查髋部手术后 IV NOA 用于术后疼痛管理效果的研究。我们比较了 IV NOA 组和对照组在入院时的阿片类药物使用量、术后视觉模拟评分(VAS)、住院时间和与阿片类药物相关的不良反应。

共纳入 7 项研究,总计 953 例接受髋部手术的患者。其中,478 例接受 IV NOA 治疗,475 例未接受。IV NOA 组在髋部手术后 24 小时内的阿片类药物使用量较低(SMD,-0.48;95%CI,-0.66 至-0.30; < 0.01),VAS 评分较低(SMD,-0.47;95%CI,-0.79 至-0.16; < 0.01),住院时间较短(SMD,-0.28;95%CI,-0.44 至-0.12; < 0.01),恶心和呕吐的发生率较低(OR,0.32;95%CI,0.15 至 0.67; < 0.01)与对照组相比。

本荟萃分析表明,与对照组相比,髋部手术后给予 IV NOA 可能具有更有利的术后结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5a6/10673097/7a93470bb803/medicina-59-01904-g001.jpg

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