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| 无阿片麻醉对全身麻醉手术患者术后恢复质量的影响：Meta分析 |
| Effect of opioid-free anesthesia on postoperative quality of recovery in patients undergoing general anesthesia surgery: a meta-analysis |
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| DOI：10.12089/jca.2026.08.011 |
| 中文关键词: 全身麻醉 恢复质量 无阿片麻醉 荟萃分析 |
| 英文关键词: General anesthesia Quality of recovery Opioid-free anesthesia Meta-analysis |
| 基金项目:连云港市卫生科技项目（202535） |
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| 中文摘要: |
目的： 系统评价无阿片麻醉对全身麻醉手术患者术后恢复质量的影响。
方法： 计算机检索中国知网、万方、维普、中国生物医学文献数据库（CBM）、Pubmed、Embase、Cochrane Library、Web of Science等数据库，收集无阿片麻醉对全身麻醉手术患者术后恢复质量的随机对照试验，检索时间为建库至2024年11月，采用RevMan 5.3软件进行统计分析。
结果： 共纳入23篇随机对照试验，共计2 703例患者，其中无阿片麻醉组1 352例，对照组1 351例。荟萃分析结果显示，与对照组比较，无阿片麻醉组术后24 h恢复质量评分明显升高（SMD=1.07，95%CI 0.74～1.41，P<0.001），术后住院时间明显缩短（MD=-0.60 d，95%CI -1.00～-0.20 d，P=0.003），术后恶心呕吐发生率明显降低（RR=0.45，95%CI 0.38～0.53，P<0.001），PACU停留时间明显延长（MD=2.77 min，95%CI 0.23～5.31 min，P=0.03）。
结论： 无阿片麻醉可有效降低全身麻醉患者术后恶心呕吐发生率，在改善全身麻醉手术患者术后早期恢复质量、缩短住院时间、延长PACU停留时间等指标循证证据不足，未来仍需高质量临床试验进一步论证。 |
| 英文摘要: |
Objective: To evaluate the effect of opioid-free anesthesia on postoperative quality of recovery (QoR) in patients undergoing general anesthesia surgery.
Methods: Databases such as CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, and Web of Science were searched to collect randomized controlled trials of opioid-free anesthesia on postoperative recovery quality of patients undergoing general anesthesia surgery. The search covered all publications up to November 2024. Statistical analysis was performed using RevMan 5.3 software.
Results: Twenty-three randomized controlled trials involving 2 703 patients were included, including 1 352 patients in the opioid-free anesthesia group and 1 351 patients in the control group. The results of meta-analysis showed that, compared with the control group, the global QoR score at postoperative 24 hours in the opioid-free anesthesia group was significantly higher (SMD = 1.07, 95% CI 0.74 to 1.41, P < 0.001), the length of stay in the hospital was significantly shorter (MD = -0.60 days, 95% CI -1.00 to -0.20 days, P = 0.003), the incidence of postoperative nausea and vomiting was significantly reduced (RR=0.45, 95% CI 0.38 to 0.53, P < 0.001), the length of stay in PACU was slightly longer (MD = 2.77 minutes, 95% CI 0.23 to 5.31 minutes, P = 0.03).
Conclusion: Opioid-free anesthesia effectively reduced the incidence of postoperative nausea and vomiting in patients undergoing general anesthesia. However, there was insufficient evidence to support its effectiveness in improving early postoperative recovery, shortening hospital stays, or prolonging the PACU stay. Further high-quality clinical trials are needed to validate these claims. |
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