羟考酮超前镇痛方案有效性与安全性的系统评价与Meta分析  

The Effectiveness and Safety of Oxycodone Hyperalgesia Scheme:a Systemic Review and Meta-analysis based on the Randomize Clinical Trials

作　　者：乐婷[1] 杨勇[1] 肖娈 商媛媛 李平[2] LE Ting;YANG Yong;XIAO Luan;SHANG Yuanyuan;LI Ping(Department of Anesthesiology,North China Petroleum Administration General Hospital,Renqiu Hebei 062552,China)

机构地区：[1]华北石油管理局总医院麻醉科,河北任丘062552 [2]华北石油管理局总医院二部医院耳鼻喉科,河北任丘062552

出　　处：《中国急救复苏与灾害医学杂志》2024年第6期801-806,共6页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省卫生健康委员会2022医学科学研究计划项目(编号:20221556)。

摘　　要：目的通过系统综述和Meta分析评价羟考酮超前镇痛方案对手术患者的有效性与安全性。方法计算机检索英文数据库(PubMed,Medline,Web of Science,Embase,Cochrane图书馆)及中文数据库[中国学术期刊全文数据库(CNKI)、中国生物医学文献数据光盘数据库(CBM disc)及维普数据库(VIP)]纳入涉及羟考酮超前镇痛相关的各类型研究。文献检索时间为数据库建立至2023年6月30日。评价指标包括:术后患者疼痛视觉评分(VIS),术后并发症发生率。用RevMan 5.4和SPSS 23.0软件进行统计学分析。结果检出文献13810篇,根据纳入标准最终入选15篇文献进行系统评价,10项RCT研究进入Meta分析;共入选病例890例。与对照组(生理盐水或安慰剂)患者相比,羟考酮超前镇痛组患者术后8 h/12 h疼痛VIS评分(IV=-1.00,95%CI:-1.21~-0.78,P<0.001)、术后4 h/6 h疼痛VIS评分(IV=-1.06,95%CI:-1.50~-0.62,P<0.001)、术后24 h疼痛VIS评分(IV=-0.53,95%CI:-0.86~-0.20,P=0.002)存在显著差异,羟考酮超前镇痛组患者疼痛评分更低;两组患者术后不良反应发生率(OR=0.34,95%CI:0.17~0.7,P=0.003)存在显著差异,羟考酮超前镇痛组患者术后不良反应发生率更低,差异均有统计学意义(P<0.05)。结论羟考酮超前镇痛方案可以广泛应用于外科手术的麻醉实践中,其有效性和安全性得到验证。具有术后患者疼痛更轻,不良反应发生更少的优势。Objectives To evaluate the effectiveness and safety of oxycodone preemptive analgesia regimen in surgical patients by systematic review and Meta-analysis method.Methods Computerized searches were performed on PubMed,Medline,Web of Science,Embase,Cochrane Library,China Academic Journal Full Text Database(CNKI),China Biomedical Literature Data on CD-ROM(CBM disc),and Vip database(VIP).Various types of studies related to oxycodone hyperalgesia were included,and the search period was from the establishment of the database to June 30th 2023.Evaluation metrics included:postoperative visual scores of patient pain,and rates of related postoperative complications.Statistical analysis was performed using RevMan 5.4 and SPSS 23.0 software.Results A total of 13,810 articles were retrieved,and 15 articles met the inclusion criteria for the systematic review.Among them,10 randomized controlled trials(RCTs)were included in the meta-analysis,involving 890 cases.Compared with patients in the control group(saline or placebo),patients in the oxycodone preemptive analgesia group had postoperative 8h/12h pain VIS scores(IV=-1.00,95%CI:from-1.21 to-0.78,P<0.001),postoperative 4 h/6 h pain VIS scores(IV=-1.06,95%CI:from-1.50 to-0.62,P<0.001),24 h postoperative pain VIS score(IV=-0.53,95%CI:from-0.86 to-0.20,P=0.002)were significantly different,and the pain scores of patients in the oxycodone preemptive analgesia group were lower;there was a significant difference in the incidence of postoperative adverse reactions between the two groups of patients(OR=0.34,95%CI:0.17-0.7,P=0.003),and the incidence of adverse reactions of patients in the oxycodone preemptive analgesia group was lower,and the differences were all statistically Significance.Conclusion The preemptive analgesia protocol with hydrocodone can be widely applied in the anesthetic practice of surgical procedures,and its effectiveness and safety have been validated.It offers advantages such as lighter postoperative pain in patients and a lower incidence of adverse reactions.

关 键 词：羟考酮 超前镇痛 系统评价 META分析 

分 类 号：R614[医药卫生—麻醉学]