小剂量纳洛酮对阿片类药物作为局麻药佐剂用于臂丛神经阻滞效果的Meta分析  

Effect of low-dose naloxone on the efficacy of opioids as local anesthetic adjuvants for brachial plexus blocks:a Meta-analysis

作　　者：徐宁[1] 于永泉 荣伟 Xu Ning;Yu Yongquan;Rong Wei(Department of Anesthesiology,Weihai Central Hospital affiliated to Qingdao University,Weihai City,Shandong Province 264400,China;Department of Science and Education,Weihai Central Hospital affiliated to Qingdao University,Weihai City,Shandong Province 264400,China)

机构地区：[1]青岛大学附属威海市中心医院麻醉科,山东省威海市264400 [2]青岛大学附属威海市中心医院科教科,山东省威海市264400

出　　处：《中华疼痛学杂志》2024年第5期709-716,共8页Chinese Journal Of Painology

摘　　要：目的:采用Meta分析评价小剂量纳洛酮对阿片类药物作为局麻药佐剂用于臂丛神经阻滞效果的影响。方法:计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方医学网和维普资讯数据库,限定检索时间截止至2024年7月。纳入探讨小剂量纳洛酮对阿片类药物作为局麻药佐剂用于臂丛神经阻滞效果影响的随机对照试验。应用R studio软件调用"Meta"和"dmetar"程序包进行Meta分析。结果:共纳入3篇文献,纳洛酮组66例,对照组68例。Meta分析显示:与对照组相比,纳洛酮组感觉[SMD=2.15,95%CI(1.72,2.59)]和运动[SMD=1.82,95%CI(0.59,3.05)]阻滞持续时间延长,术后不良反应发生率[OR=0.27,95%CI(0.11,0.67)]降低。两组术后视觉模拟评分(VAS)[MD=-0.62,95%CI(-1.60,0.36)]和感觉阻滞起效时间[MD=2.14,95%CI(-2.97,7.26)]差异不明显。另外,与对照组相比,纳洛酮组运动[MD=1.10,95%CI(0.43,1.78)]阻滞起效时间延长。结论:在阿片类药物作为局麻药佐剂基础上添加小剂量纳洛酮,可以进一步延长臂丛神经阻滞效果,减少术后不良反应,不影响术后镇痛效果。Objective To evaluate the effect of low-dose naloxone on the efficacy of opioids as local anesthetic adjuvants for brachial plexus nerve block by Meta-analysis.Methods A computerized search of PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang,and VIP databases was performed,with a limited search period ending August 2024.Randomized controlled trials of low-dose naloxone on the efficacy of opioids as local anesthetics adjuvants for brachial plexus blocks were included and Meta-analysis was performed using R studio software with the"Meta"and"dmetar"packages.Results Three papers were included with 66 patients in the naloxone group and 68 patients in the control group.This results showed that the duration of sensory[SMD=2.15,95%CI(1.72,2.59)]and motor[SMD=1.82,95%CI(0.59,3.05)]block was prolonged,and the rate of postoperative adverse events[OR=0.27,95%CI(0.11,0.67)]was reduced in the naloxone group than that in the control group.The differences in postoperative visual analogue scale(VAS)score[MD=-0.62,95%CI(-1.60,0.36)]and sensory block onset time[MD=2.14,95%CI(-2.97,7.26)]were not significant between the two groups.In addition,motor[MD=1.10,95%CI(0.43,1.78)]block onset time was prolonged in the naloxone group than that in the control group.Conclusion Adding low-dose naloxone to opioids as local anesthetic adjuvants prolongs the effect of brachial plexus block,reduces postoperative adverse events,and does not compromise postoperative analgesia.

关 键 词：纳洛酮 镇痛药 阿片类 镇痛 臂丛 神经传导阻滞 META分析 

分 类 号：R59[医药卫生—内科学]