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| 地佐辛复合氟比洛芬酯用于术后自控镇痛效果的Meta分析 |
| Efficacy and safety of dezocine plus flurbiprofen axetil versus sufentanil on postoperative patient-controlled intravenous analgesia: a Meta-analysis |
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| DOI：10.12089/jca.2018.12.017 |
| 中文关键词: 地佐辛 氟比洛芬酯 舒芬太尼 患者自控静脉镇痛 |
| 英文关键词: Dezocine Flurbiprofen axetil Sufentanil Patient-controlled intravenous analgesia |
| 基金项目: |
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| 中文摘要: |
目的 采用Meta分析系统评价地佐辛复合氟比洛芬酯用于术后患者自控静脉镇痛(PCIA)的效果和安全性。
方法 在PubMed、EMBASE、CENTRAL、Web of Science、中国生物医学文献数据库、知网、万方数据库中进行文献检索,截止时间为2018年2月。纳入比较地佐辛复合氟比洛芬酯与舒芬太尼用于术后PCIA疗效和安全性的随机对照试验(RCT)。采用Jadad量表评估研究质量,采用Stata 14.0软件进行统计分析。
结果 共纳入15项中文RCTs。与舒芬太尼组比较,地佐辛复合氟比洛芬酯组术后4 h(SMD=-0.34,95％ CI -0.64～-0.04,P=0.028)和12 h(SMD=-0.26,95％ CI -0.47～-0.06,P=0.013)的VAS疼痛评分,术后6 h(SMD=-1.71,95％ CI -3.28～-0.13,P=0.033)、12 h(SMD=-0.71,95％ CI -1.35～-0.07,P=0.029)和48 h(SMD=-0.15,95％ CI -0.29～-0.02,P=0.024)的Ramsay镇静评分均明显降低;术后24 h的镇静泵按压次数明显减少(SMD=-1.67,95％CI -3.30～-0.05,P=0.043)。与舒芬太尼组比较,地佐辛复合氟比洛芬酯组不良事件如恶心呕吐、嗜睡、头晕、眩晕、头痛、皮肤瘙痒、寒战和出汗等发生率明显降低(OR均<0.5,P<0.05)。
结论 地佐辛复合氟比洛芬酯用于术后PCIA优于舒芬太尼,具有较好的镇痛效果,并且不良反应少。 |
| 英文摘要: |
Objective To systematically review the efficacy and safety of the combination therapy of dezocine with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia (PCIA) management.
Methods A literature search was performed in databases such as PubMed, EMBASE, CENTRAL, Web of Science, Chinese biomedical literature service system (Sinomed), China National Knowledge Infrastructure (CNKI) and WanFang up to Feb, 2018. Only randomized controlled trails (RCTs) comparing the efficacy and safety of dezocine plus flurbiprofen axetil with sufentanil on PCIA were eligible for the Meta-analysis. The Jadad scale was utilized to evaluate study quality. The Stata 14.0 software was used to perform statistical analysis.
Results Fifteen Chinese RCTs were included in this Meta-analysis. Compared with sufentanil group, dezocine plus flurbiprofen axetil group had a significantly lower visual analogue score (VAS) at postoperative 4 h [standardized mean differences （SMD）=-0.34, 95％ CI -0.64 to -0.04, P=0.028] and 12 h (SMD=-0.26, 95％ CI -0.47 to -0.06, P=0.013); a significantly reduced Ramsay sedation score at postoperative 6 h (SMD=-1.71, 95％ CI -3.28 to -0.13, P=0.033), 12 h (SMD=-0.71, 95％ CI -1.35 to -0.07, P=0.029) and 48 h (SMD=-0.15, 95％ CI -0.29 to -0.02, P=0.024); and a significantly less times of pressing analgesia pump at postoperative 24 h (SMD=-1.67, 95％ CI -3.30 to -0.05, P=0.043). Furthermore, compared with sufentanil group, dezocine plus flurbiprofen axetil group significantly reduced incidences of adverse effects such as nausea/vomiting, drowsiness, dizziness/vertigo/headache, skin itch, shivering and sweat [odds ratio (OR)<0.5, P<0.05].
Conclusion The combination of dezocine with flurbiprofen axetil is superior over sufentanil for preventing pain on postoperative PCIA in China. |
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