Albazee Ebraheem, Allafi Fahad, Alsalem Abdulwahab, AlShaya Deemah, Alhazami Hayfaa, Alfalah Danah
Otorhinolaryngology-Head and Neck Surgery Kuwait Institute for Medical Specializations (KIMS) Kuwait City Kuwait.
Department of General Surgery, Al-Jahra Hospital Ministry of Health Al Jahra Kuwait.
OTO Open. 2025 May 5;9(2):e70124. doi: 10.1002/oto2.70124. eCollection 2025 Apr-Jun.
To evaluate the analgesic role of ropivacaine local infiltration in patients undergoing thyroidectomy.
PubMed, Google Scholar, CENTRAL, Scopus, and Web of Science.
A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs). Our specific endpoints include pain severity, total opioid analgesia consumption, patient satisfaction, length of hospital stay, postanesthesia care unit (PACU) length of stay, surgery duration, and the incidence of postoperative nausea and vomiting (PONV). Using Stata, we pooled dichotomous outcomes and continuous outcomes using risk ratio (RR) and standardized mean difference (SMD) or mean difference (MD), respectively, with a 95% confidence interval (CI).
Eight RCTs and 633 patients were included. Ropivacaine significantly decreased pain after 1 to 2 hours postoperatively (SMD: -1.40, 95% CI [-2.30, -0.51]). However, there was no difference between both groups after 4 hours ( = .11), 6 to 8 hours ( = .05), 16 to 18 hours ( = .10), and 24 hours ( = .37). Also, ropivacaine significantly decreased analgesia consumption (SMD: -0.75, 95% CI [-1.30, -0.20]), with no effect on surgery duration ( = .59), length of hospital stays ( = .32), patient satisfaction score ( = .25), and PACU length of stay ( = .25). Finally, there was no difference between both groups regarding the incidence of PONV (RR: 1.01, 95% CI [0.70, 1.45]).
Ropivacaine local infiltration after thyroidectomy significantly decreased pain for up to 1 to 2 hours and analgesia consumption compared to control, but with uncertain evidence. However, ropivacaine had no effect on pain from 4 to 24 hours, surgery duration, length of PACU stay, length of hospital stay, and patient satisfaction.
评估罗哌卡因局部浸润在甲状腺切除术中的镇痛作用。
PubMed、谷歌学术、CENTRAL、Scopus和科学网。
一项系统评价和荟萃分析，综合来自随机对照试验（RCT）的证据。我们的具体终点包括疼痛严重程度、阿片类镇痛药总消耗量、患者满意度、住院时间、麻醉后护理单元（PACU）停留时间、手术时长以及术后恶心呕吐（PONV）的发生率。使用Stata软件，我们分别采用风险比（RR）和标准化均数差（SMD）或均数差（MD）对二分类结局和连续型结局进行合并，并给出95%置信区间（CI）。
纳入8项RCT研究，共633例患者。罗哌卡因显著降低术后1至2小时的疼痛（SMD：-1.40，95%CI[-2.30，-0.51]）。然而，4小时（P = 0.11）、6至8小时（P = 0.05）、16至18小时（P = 0.10）和24小时（P = 0.37）时两组之间无差异。此外，罗哌卡因显著降低镇痛药消耗量（SMD：-0.75，95%CI[-1.30，-0.20]），对手术时长（P = 0.59）、住院时间（P = 0.32）、患者满意度评分（P = 0.25）和PACU停留时间（P = 0.25）无影响。最后，两组在PONV发生率方面无差异（RR：1.01，95%CI[0.70，1.45]）。
与对照组相比，甲状腺切除术后罗哌卡因局部浸润可显著减轻长达1至2小时的疼痛并减少镇痛药消耗量，但证据尚不明确。然而，罗哌卡因对4至24小时的疼痛、手术时长、PACU停留时间、住院时间和患者满意度无影响。
