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右美托咪定用于膝关节镜检查疼痛管理的疗效:一项系统评价和荟萃分析。

Efficacy of dexmedetomidine for pain management in knee arthroscopy: A systematic review and meta-analysis.

作者信息

Li Chen, Qu Ji

机构信息

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, P. R. China.

出版信息

Medicine (Baltimore). 2017 Oct;96(43):e7938. doi: 10.1097/MD.0000000000007938.

Abstract

BACKGROUND

Dexmedetomidine showed some potential in pain control in patients undergoing knee arthroscopy. We conducted a systematic review and meta-analysis to explore the efficacy of dexmedetomidine in patients undergoing knee arthroscopy.

METHODS

We searched the randomized controlled trials (RCTs) assessing the effect of dexmedetomidine on knee arthroscopy in PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. The primary outcome was pain scores. Meta-analysis was performed using the random-effect model.

RESULTS

Five RCTs were included. Overall, compared with control intervention in patients with knee arthroscopy, dexmedetomidine intervention could significantly reduce the pain scores [Std. mean difference = -0.84; 95% confidence interval (95% CI) = -1.24 to -0.44; P < .0001] and postoperative diclofenac sodium consumption (Std. mean difference = -1.76; 95% CI = -3.32 to -0.21; P = .03), improve duration of analgesic effect (Std. mean difference = 1.78; 95% CI = 0.56-3.00; P = .004), but showed no influence on hypotension [risk ratio (RR) = 0.93; 95% CI = 0.14-5.92; P = .94], bradycardia (RR = 4.93; 95% CI = 0.91-26.58; P = .06), nausea, and vomiting (RR = 1.96; 95% CI = 0.31-12.58; P = .48).

CONCLUSION

Dexmedetomidine intervention was able to significantly reduce the pain scores and postoperative diclofenac sodium consumption, and improve duration of analgesic effect in patients undergoing knee arthroscopy, but had no influence on hypotension, bradycardia, nausea, and vomiting.

摘要

背景

右美托咪定在膝关节镜手术患者的疼痛控制方面显示出一定潜力。我们进行了一项系统评价和荟萃分析,以探讨右美托咪定在膝关节镜手术患者中的疗效。

方法

我们在PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库中检索了评估右美托咪定对膝关节镜手术效果的随机对照试验(RCT)。主要结局是疼痛评分。采用随机效应模型进行荟萃分析。

结果

纳入了5项RCT。总体而言,与膝关节镜手术患者的对照干预相比,右美托咪定干预可显著降低疼痛评分[标准化均数差=-0.84;95%置信区间(95%CI)=-1.24至-0.44;P<.0001]和术后双氯芬酸钠消耗量(标准化均数差=-1.76;95%CI=-3.32至-0.21;P=.03),改善镇痛效果持续时间(标准化均数差=1.78;95%CI=0.56-3.00;P=.004),但对低血压[风险比(RR)=0.93;95%CI=0.14-5.92;P=.94]、心动过缓(RR=4.93;95%CI=0.91-26.58;P=.06)、恶心和呕吐(RR=1.96;95%CI=0.31-12.58;P=.48)无影响。

结论

右美托咪定干预能够显著降低膝关节镜手术患者的疼痛评分和术后双氯芬酸钠消耗量,并改善镇痛效果持续时间,但对低血压、心动过缓、恶心和呕吐无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/459b/5671813/8760ce862d78/medi-96-e7938-g001.jpg

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