地佐辛与舒芬太尼用于术后病人硬膜外自控镇痛效果及安全性的比较：meta分析  

Efficacy and safety of dezocine versus sufentanil for postoperative patient-controlled epidural analgesia： a meta-analysis

作　　者：吴耀华[1] 胡亮[1] 郝泉水 陈清华[1] 徐启菊[2] 

机构地区：[1]黄冈市中心医院麻醉科,438000 [2]黄冈市中心医院药剂科,438000

出　　处：《中华麻醉学杂志》2015年第6期714-717,共4页Chinese Journal of Anesthesiology

摘　　要：目的 采用meta分析方法比较地佐辛与舒芬太尼用于术后病人硬膜外自控镇痛的效果及安全性.方法 检索PubMed、EMBASE、Cochrane Library、ISI Web of knowledge、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库及万方数据库中地佐辛和舒芬太尼用于术后病人硬膜外自控镇痛的随机对照研究,检索时间均从建库至2014年4月.按照纳入标准筛选文献、提取资料,按照Cochrane系统评价员手册5.1.0推荐的相关标准,对纳入文献的质量进行评价,采用RevMan 5.1进行meta分析.结果 纳入7项研究,均为中文文献,共760例患者.meta分析结果显示：（1）VAS评分：术后4、8、12、16、24和48 h时2组VAS评分差异无统计学意义（P＞0.05）;（2）Ramsay镇静评分：术后4、12、24和48 h时2组Ramsay镇静评分差异无统计学意义（P＞0.05）;（3）不良反应：地佐辛组不良反应（恶心呕吐、皮肤瘙痒、尿潴留和嗜睡）发生率低于舒芬太尼组（P＜0.05）,术后呼吸抑制和头晕发生率差异无统计学意义（P＞0.05）.结论 地佐辛用于术后病人硬膜外自控镇痛的效果及安全性优于舒芬太尼.Objective To evaluate the efficacy and safety of dezocine versus sufentanil for postoperative patient-controlled epidural analgesia （PCEA）.Methods PubMed,EMBASE,Cochrane Library,ISI Web of knowledge,Chinese Biomedical Database,Chinese Science-Technology Journal Database,China Journal Full-text Database and Wanfang Database were searched for randomized controlled trials involving the efficacy and safety of dezocine and sufentanil for PCEA from the date of database establishment up to April 2014.Randomized controlled trials met the inclusion criteria were included,and the data were extracted.The quality of the trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.1 software.Results Seven studies involving 760 patients were included in this meta-analysis.The results of meta-analyses showed that there was no significant difference between dezocine group and sufentanil group in VAS scores at 4,8,12,16,24 and 48 h after surgery and in Ramsay sedation scores at 4,12,24 and 48 h after surgery,and the incidence of adverse reactions （postoperative nausea and vomiting,pruritus,urinary retention and somnolence） was significantly lower in dezocine group than in sufentanil group,and there was no significant difference in the incidence of respiratory depression and dizziness between dezocine group and sufentanil group.Conclusion Dezocine provides better efficacy and safety for postoperative PCEA than sufentanil.

关 键 词：镇痛药 阿片类 舒芬太尼 镇痛 硬膜外 META分析 

分 类 号：R614[医药卫生—麻醉学]