摘要
目的采用meta分析评价地佐辛和氟比洛芬酯联合用药与单用舒芬太尼在术后静脉自控镇痛中的有效性与安全性。方法系统检索Pub Med、Web of science、Embase、Cochrane图书馆、CNKI、VIP、Wan Fang、CBMdisc等数据库,收集地佐辛联合氟比洛芬酯术后静脉自控镇痛的随机对照试验(RCT),采用Rev Man 5.3软件进行Meta分析。结果共纳入有效文献11篇,累计936名患者。Meta分析结果显示:(1) VAS评分:联合用药组在术后4 h和8 h的VAS评分均较单用舒芬太尼组低,且差异均具有统计学意义(P <0.05);(2) Ramsay评分:联合用药组在术后36 h镇静效果较单用舒芬太尼更为显著[WMD=0.05,95%CI(0.01,0.10),P=0.02];(3)病人自控镇痛(PCA)有效按压次数:联合用药组在术后24 h和48 h时这两个时间点的PCA有效按压次数较单用舒芬太尼组低[WMD=-1.45,95%CI(-6.04,3.01),P<0.01;WMD=-1.52,95%CI(-6.20,3.18),P <0.01];(4)安全性:与舒芬太尼单用组相比,联合用药组术后恶心呕吐、皮肤瘙痒及总发生率显著降低。结论与单用舒芬太尼相比,地佐辛复合氟比洛芬酯用于静脉自控镇痛(PCIA)能获得较好的临床镇痛效果,并有效降低不良发应发生率,临床应用更为安全。
Objective To evaluate the efficacy and safety of dezocine combined with flurbiprofen axetil versus sufenta for patient-controlled analgesia(PCA). Methods The randomized controlled trials of dezocine combined with flurbiprofen axetil for PCA were gathered from PubMed, Web of science, Embase, Cochrane library, CNKI, VIP, Wan Fang and CBMdisc Data. After data extraction and quality assessment of the included RCTs, Rev Man 5.3 software was used in the meta-analysis. Results Eleven trials comprising 936 patients were included in the meta-analysis.(1) Compared with the sufentanil group, the visual analog scale(VAS) score of the combination group had significant differences at 4-hour and 8-hour post-operation;(2) Compared with the sufentanil group, the ramsay sedation score at 24-hour and 48-hour had significant differences when dezocine was combined with flurbiprofen axetil(WMD = 0.05, 95%CI(0.01, 0.10), P = 0.02);(3) As for the effective number of press in the PCA, the combined group was better than the single sufentanil group at 24 h and 48 h [WMD =-1.45, 95%CI(-6.04, 3.01), P<0.01;WMD =-1.52, 95%CI(-6.20, 3.18), P<0.01];(4) Comparision of adverse reactions in the combination group with those of the single sufentanil group, nausea and vomiting, skin itching and incidences of adverse reaction were all significantly decreased. ConclusionAccording to domestic evidence, dezocine combined with flurbiprofen axetil for PCA may more effectively alleviate post-operative pain than sufentanil alone, and can reduce the incindence of adverse reactions.
作者
陈鹏
周本宏
陈富超
雷洁昕
CHEN Peng;ZHOU Ben-hong;CHEN Fu-chao;LEI Jie-xin(Department of Pharmacy,Renmin Hospital of Wuhan University,Wuhan 430060;Department of Pharmacy,Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan Hubei 442008;Department of Endocrinology,Renmin Hospital of Wuhan University,Wuhan 430060)
出处
《中南药学》
CAS
2019年第2期186-191,共6页
Central South Pharmacy
基金
湖北省卫生计生科研基金项目(No.WJ2015MB290)
十堰市科技计划项目(No.16Y66)
关键词
地佐辛
氟比洛芬酯
舒芬太尼
术后静脉自控镇痛
META分析
dezocine
flurbiprofen axetil
sufentanil
postoperative patient-controlled intravenous analgesia
meta-analysis
