超声引导下腹横肌平面阻滞用于小儿下腹部手术术后镇痛有效性和安全性的Meta分析  

Efficacy and safety of ultrasound-guided transverses abdominis plane block for children abdominal surgery postoperative analgesia:A metaanalysis

作　　者：林胜仙 孔微微[2] 李军[2] 徐旭仲[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科,浙江温州325000 [2]温州医科大学附属第二医院麻醉科,浙江温州325027

出　　处：《中国现代医生》2016年第14期109-113,118,共6页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2012ZDA036)

摘　　要：目的采用Meta分析方法比较超声引导下腹横肌平面阻滞用于小儿下腹部手术术后镇痛的效果及安全性。方法检索Pub Med、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腹横肌平面阻滞用于小儿术后镇痛的随机对照研究,检索时间均从建库至2016年1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Rev Man 5.1进行Meta分析。结果纳入8项研究,均为中文文献,共560例患者。Meta分析结果显示:疼痛评分:术后2、4、12 h时两组间VAS评分,术后2、4、8、12 h时两组间CHEOPS评分和术后1、4、8 h时两组间FLACC评分差异有统计学意义(P<0.05);实验组术后镇痛效果满意度高于对照组(P<0.05),按压次数明显少于对照组(P<0.05);不良反应:实验组和对照组不良反应(恶心呕吐)发生率差异无统计学意义(P>0.05),躁动发生率差异有统计学意义(P<0.05)。结论超声引导下的腹横肌平面阻滞能安全有效地缓解小儿下腹部手术术后疼痛和术后躁动发生率,但不增加其副作用。Objective To evaluate the efficacy and safety of ultrasound-guided transverses abdominis plane block for children abdominal surgery postoperative analgesia. Methods PubMed, EM BASE, 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 ultrasound-guided transverses abdominis plane block for children abdominal surgery postoperative analgesia from the date of database establishment up to Jan 2016. Randomized controlled trials met the inclusion criteria were included, and the data were extracted.The quality of the trials was evaluated according to Coehrane Handbook 5.1.0 criteria. Meta-analysiswas conducted using RevMan 5.1 software. Results Eight studies involving 560 patients were included in this meta-analysis. The results of meta-analyses showed that there were significant difference between experimental group and controll group in VAS scores at 2, 4 and 12 h, CHEOPS scores at 2, 4, 8 and 12 h and FLACC scores at 1, 4, 8 h after surgery. The postoperative analgesia effect of the experimental group were higher than that of the control group （P〈0.05）. The cumulative number of pressing was significantly lower in experimental group than that in control group（P〈0.05）. The incidence of adverse reactions （post-operative nausea and vomiting）was no significantly difference, but the incidence of agi tation was significant difference in experimental group and controll group （P〈0.05）. Conclusion Ultrasound-guided transverses abdominis plane block can relieve postoperative pain and reduce incidence of postoperative agitation, hut has no obvious side effect in children received abdominal surgery.

关 键 词：腹横肌平面阻滞 术后镇痛 小儿 META分析 

分 类 号：R614.2[医药卫生—麻醉学]