Sun Mingyang, Cong Xuhui, Chang Enqiang, Miao Mengrong, Zhang Jiaqiang
Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
J Surg Res. 2020 Aug;252:80-88. doi: 10.1016/j.jss.2019.11.032. Epub 2020 Apr 1.
The objective of this meta-analysis is to assess the analgesic effect of flurbiprofen on postoperative pain in Chinese surgical patients.
The primary outcome was acute postoperative pain scores; the secondary outcomes included total opiate consumption during surgery and adverse effects, such as nausea, vomiting, and dizziness. Results were expressed as weighted mean difference (WMD) or odds ratio with 95% confidence intervals (95% CIs). We evaluated heterogeneity by visually examining the forest plots and quantified it by using the I statistic. We used random-effects models to pool the data.
Of 573 abstracts reviewed, 19 studies involving 1628 participants met the inclusion criteria. Pooled results showed that the intravenous administration of flurbiprofen had a beneficial effect in reducing pain scores at 2 (WMD, -0.78; 95% CI, -1.22 to -0.34; P = 0.001), 6 (WMD, -0.93; 95% CI, -1.40 to -0.46; P = 0.000), 12 (WMD, -1.09; 95% CI, -1.93 to -0.24; P = 0.011), 24 (WMD, -1.08; 95% CI, -1.48 to -0.68; P = 0.000), and 48 (WMD, -0.62; 95% CI, -1.19 to -0.05; P = 0.032) h after surgery. In addition, flurbiprofen administration significantly decreased the incidence of postoperative nausea and vomiting (odds ratio, 0.39; 95% CI, 0.26-0.58; P = 0.000) but had no effects on opiate consumption and dizziness.
The perioperative administration of flurbiprofen is effective in reducing postoperative pain, nausea, and vomiting in Chinese surgical patients. Future studies with adequate power should evaluate the ideal flurbiprofen regimen for postoperative pain.
本荟萃分析的目的是评估氟比洛芬对中国外科手术患者术后疼痛的镇痛效果。
主要结局指标为术后急性疼痛评分;次要结局指标包括手术期间阿片类药物的总消耗量以及恶心、呕吐和头晕等不良反应。结果以加权平均差(WMD)或比值比及95%置信区间(95%CI)表示。我们通过直观检查森林图评估异质性,并使用I统计量进行量化。我们采用随机效应模型汇总数据。
在审查的573篇摘要中,19项研究(涉及1628名参与者)符合纳入标准。汇总结果显示,静脉注射氟比洛芬在术后2小时(WMD,-0.78;95%CI,-1.22至-0.34;P = 0.001)、6小时(WMD,-0.93;95%CI,-1.40至-0.46;P = 0.000)、12小时(WMD,-1.09;95%CI,-1.93至-0.24;P = 0.011)、24小时(WMD,-1.08;95%CI,-1.48至-0.68;P = 0.000)和48小时(WMD,-0.62;95%CI,-1.19至-0.05;P = 0.032)时对减轻疼痛评分有有益作用。此外,使用氟比洛芬显著降低了术后恶心和呕吐的发生率(比值比,0.39;95%CI,0.26 - 0.58;P = 0.000),但对阿片类药物消耗量和头晕无影响。
围手术期使用氟比洛芬对减轻中国外科手术患者的术后疼痛、恶心和呕吐有效。未来有足够效力的研究应评估用于术后疼痛的理想氟比洛芬方案。