非甾体抗炎药在儿童日间手术中有效性和安全性的Meta分析  

Meta-analysis of efficacy and safety of non-steroid anti-inflammatory drugs in paediatric day surgery

作　　者：孙文冲[1] 尹秀茹[1] 张硕[1] 刘玉文 裴凌[1] SUN Wenchong;YIN Xiuru;ZHANG Shuo;LIU Yuwen;PEI Ling(Department of Anesthesiology,the First Af-filiated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院麻醉科

出　　处：《中国临床药学杂志》2020年第1期42-47,共6页Chinese Journal of Clinical Pharmacy

基　　金：国家自然科学基金(编号81701121)

摘　　要：目的系统评价非甾体抗炎药(NSAIDs)用于儿童日间手术的镇痛效果。方法独立计算机检索EMBASE、Cochrane图书馆、PubMed、CNKI、CBM和万方数据库,查找已发表的使用NSAIDs作为儿童日间手术镇痛药物的文献。检索时限为建库至2018年7月29日。按Cochrane系统评价方法对纳入的文献进行质量评价,同时提取纳入文献的数据,采用RevMan 5.3软件对纳入文献进行Meta分析。结果通过检索和筛选,最终纳入17篇文献,总计1531例患儿(试验组920例、对照组611例)。在围术期给予NSAIDs可显著降低日间手术术后4 h[标准化均数差=-1.05,95%可信区间(-1.67,-0.43),P=0.0008]及第1个24 h以内[标准化均数差=-0.63,95%可信区间(-0.96,-0.29),P=0.0003]的疼痛评分;显著减少在麻醉恢复室(PACU)[加权均数差=-39.63,95%可信区间(-45.66,-33.61),P<0.00001]与术后病房内的吗啡累计使用量[加权均数差=-54.13,95%可信区间(-88.47,-19.79),P=0.002]。NSAIDs不能降低术后恶心呕吐发生率[比值比=0.86,95%可信区间(0.64,1.15),P=0.3]。结论NSAIDs可显著缓解日间手术患儿术后镇痛,减少阿片类药物的用量。AIM To systematically evaluate the influence of non-steroid anti-inflammatory drugs(NSAIDs)on paediatric patients in day surgery.METHODS Two researchers independently searched the EMBASE,Co-chrane Library,PubMed,CNKI,CBM and Wanfang databases from inception to July 29th,2018.All included randomized controlled trials(RCTs)were selected according to the standard of Cochrane systematic evaluation method.The data were extracted and assessed.The RevMan 5.3 software was used for Meta-analysis.RESULTS A total of 17 RCTs involving 1531 patients(NSAIDs-treated group 920 cases and control group 611 cases)were included.The results of Meta-analysis showed that NSAIDs significantly reduced the pain scale scores 4 h after op-eration[standardized mean difference(SMD)=-1.05,95%confidence interval(CI)(-1.67,-0.43),P=0.0008]and within the first 24 h[SMD=-0.63,95%CI(-0.96,-0.29),P=0.0003]in day surgery.In postanes-thesia care unit(PACU),the morphine dose showed a significant decrease[weighted mean difference(WMD)=-39.63,95%CI(-45.66,-33.61),P<0.00001]in NSAIDs-treated groups.The cumulative morphine con-sumption of the NSAIDs-treated groups was significantly less than that of the control groups in wards[WMD=-54.13,95%CI(-88.47,-19.79),P=0.002].The occurrence of posto perative nausea and vomiting[rate ratio(RR)=0.86,95%CI(0.64,1.15),P=0.3]was not significantly declined in NSAIDs-treated groups.CONCLUSION NSAIDs can dramatically relieve the postoperative pain in paediatric day surgery.Mean-while,the cumulative doses of morphine are saved in PACU and wards.

关 键 词：非甾体抗炎药 日间手术 儿童 疼痛 META分析 

分 类 号：R95[医药卫生—药学]