局部浸润镇痛对髋关节置换术后镇痛效果及安全性的Meta分析  

Local Infiltration Analgesia for Postoperative Pain after Hip Arthroplasty:A Meta-analysis

作　　者：张慧伟[1] 刘凯[2] 庞波[1] 卢文江 王红川[2] 蒋俊威 

机构地区：[1]乐山市人民医院麻醉科,四川乐山614000 [2]乐山市人民医院骨科,四川乐山614000

出　　处：《华西医学》2016年第7期1220-1226,共7页West China Medical Journal

摘　　要：目的通过Meta分析研究局部浸润镇痛对髋关节置换术后的镇痛效果及安全性。方法检索Cochrane图书馆、Embase、Pub Med、中国知网数据库、维普中文科技期刊数据库、万方数据库等,收集建库至2016年5月所有比较局部浸润镇痛与无局部浸润镇痛(对照组)镇痛效果及不良反应发生率的随机对照试验,比较两组间的疼痛评分、不良反应事件发生率。采用Rev Man 5.2.0软件进行Meta分析。结果共纳入12篇随机对照研究。Meta分析结果显示:术后静息时两组间疼痛评分差异有统计学意义[WMD=-19.06分,95%CI(-21.51,-16.62)分,P<0.000 01],术后活动时两组疼痛评分差异有统计学意义[WMD=-11.45分,95%CI(-15.56,-7.34)分,P<0.000 01]。术后恶心呕吐发生率差异有统计学意义[RR=0.59,95%CI(0.42,0.84),P=0.003],局部浸润镇痛组疼痛程度及恶心呕吐发生率低于对照组;而两组术后尿潴留、皮肤瘙痒、低血压发生率差异均无统计学意义(P>0.005)。结论局部浸润镇痛对髋关节置换术后镇痛具有安全性及有效性,该镇痛模式能有效缓解髋关节置换术后疼痛,且不增加不良反应事件。Objective To evaluate the impact of local infiltration analgesia on postoperative pain after hip arthroplasty.Methods Relevant randomized controlled trials comparing the analgesia effect and adverse effects between local infiltration analgesia group and non-local infiltration analgesia group（control group） were identified from Cochrane Library,Embase,PubMed,China National Knowledge Infrastructure,VIP database and Wanfang database from their establishment until May 2016.A systematic review was performed to compare the pain scores and adverse events between those two groups.Effective data were pooled for Meta-analysis with software RevMan 5.2.0.Results Twelve eligible trials were identified in this study.The pain scores of the two groups of patients during rest time after surgery were significantly different[WMD=-19.06,95%CI（-21.51,-16.62）,P〈 0.000 01];the pain scores were also significantly different during activity time[WMD=-11.45,95%CI（-15.56,-7.34）,P〈 0.000 01].There was significant difference in postoperative nausea and vomiting between the two groups[RR=0.59,95%CI（0.42,0.84）,P=0.003].The pain degree and incidence of nausea and vomiting in the local infiltration analgesia group were lower than the control group,but there was no significant difference between the two groups in terms of urinary retention,itch and hypotension（P〈 0.05）.Conclusion Local infiltration analgesia is effective in reducing postoperative pain without any additional adverse reactions.

关 键 词：局部浸润镇痛 髋关节置换术 META 分析 随机对照研究 

分 类 号：R614[医药卫生—麻醉学]