镰状细胞病患者疼痛管理中患者自控镇痛与标准阿片类镇痛疗法的比较评估：一项系统评价和荟萃分析方案
The Evaluation of Patient-Controlled Analgesia Compared to Standard Opioid Analgesic Therapy in Pain Management Among Patients With Sickle Cell Disease: A Systematic Review and Meta-Analysis Protocol.
作者信息
D'Costa Maria Pramila, Alva Melita Sheela, Nejadghaderi Seyed Aria, Al Bloushi Salha Humaid, Al Shizawi Wafa Ibrahim Saleh, Muduli Nikhil, Ahuja Sana, Al-Amri Salma, Mosavi Jarrahi Alireza, Al-Yateem Nabeel, Rahman Syed Azizur, Al-Marzouqi Amina Mohammed
机构信息
Oman College of Health Sciences-North Batinah Branch Suhar Sultanate of Oman.
Saskatchewan Indian Institute of Technology Saskatoon Canada.
出版信息
Health Sci Rep. 2025 Mar 18;8(3):e70577. doi: 10.1002/hsr2.70577. eCollection 2025 Mar.
BACKGROUND AND AIMS
Sickle cell disease (SCD) is an inherited blood disorder characterized by the production of abnormal hemoglobin S (HbS), leading to the deformation of red blood cells into a sickle shape under low oxygen conditions. These deformed cells impede blood flow, causing vaso-occlusive crises (VOCs), which result in severe pain, multiorgan damage, and increased mortality. Despite advancements in understanding the pathophysiology and management of VOCs, optimal pain management remains a significant challenge. This review aims to evaluate patient-controlled analgesia compared to standard opioid analgesic therapy in pain management among patients with SCD.
METHODS
The relevant studies will be searched using a well-formulated search strategy using databases such as PubMed, Embase, Scopus, and Web of Science. It will be screened by two reviewers independently (screening phase), and further, the third reviewer may solve if any discrepancies are noted. The primary outcomes will be pain reduction in intensity and frequency of breakthrough pain reported using a standard pain scale. The secondary outcomes will be adverse reactions, mortality rate, length of hospital stay, and 30-day readmission. Then, the eligible studies are assessed for risk for bias and quality by two review members using the Newcastle-Ottawa Scale for observational studies or Cochrane Risk of Bias assessment tool version 2. Besides, it provides strong evidence in support of patient-controlled analgesia (PCA) as an optimal pain management strategy compared to other pain management strategies. It also explores PCA's safety profiles and common adverse events to provide evidence-based recommendations and establish a standard of care for treating SCD patients.
RESULTS
PRISMA format of reporting systematic review and meta-analysis protocols will be followed while presenting the results of this study.
CONCLUSION
The findings potentially influence clinical practice, healthcare policy, and future research thereby guiding the development of evidence-based standards for VOC management in SCD patients.
TRIAL REGISTRATION
CRD42024573178.
背景与目的
镰状细胞病（SCD）是一种遗传性血液疾病，其特征是产生异常血红蛋白S（HbS），导致红细胞在低氧条件下变形为镰刀状。这些变形的细胞阻碍血液流动，引发血管闭塞性危机（VOCs），导致严重疼痛、多器官损伤和死亡率增加。尽管在理解VOCs的病理生理学和管理方面取得了进展，但最佳疼痛管理仍然是一项重大挑战。本综述旨在评估在SCD患者的疼痛管理中，与标准阿片类镇痛疗法相比，患者自控镇痛的效果。
方法
将使用精心制定的检索策略，在PubMed、Embase、Scopus和Web of Science等数据库中检索相关研究。由两名审阅者独立进行筛选（筛选阶段），如有任何差异，第三名审阅者可进行解决。主要结局将是使用标准疼痛量表报告的疼痛强度降低和爆发性疼痛的频率。次要结局将是不良反应、死亡率、住院时间和30天再入院率。然后，由两名评审成员使用纽卡斯尔-渥太华量表对观察性研究或Cochrane偏倚风险评估工具第2版，对符合条件的研究进行偏倚风险和质量评估。此外，与其他疼痛管理策略相比，它为支持患者自控镇痛（PCA）作为最佳疼痛管理策略提供了有力证据。它还探讨了PCA的安全性概况和常见不良事件，以提供基于证据的建议，并建立治疗SCD患者的护理标准。
结果
在呈现本研究结果时，将遵循PRISMA格式报告系统评价和荟萃分析方案。
结论
这些发现可能会影响临床实践、医疗保健政策和未来研究，从而指导制定SCD患者VOC管理的循证标准。
试验注册
CRD42024573178。
Zotero 插件