经神经周围和静脉内给予地塞米松在肩关节镜检查中镇痛效果的比较：一项随机对照试验的荟萃分析。
Analgesic comparison between perineural and intravenous dexamethasone for shoulder arthroscopy: a meta-analysis of randomized controlled trials.
机构信息
Department of Hand Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710054, Shaanxi, China.
Sports Medicine Center, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, No. 555 Youyidong Street, Beilin District, Xi'an, 710054, Shaanxi, China.
出版信息
J Orthop Surg Res. 2022 Feb 17;17(1):103. doi: 10.1186/s13018-022-02952-6.
INTRODUCTION
The analgesic comparison between perineural and intravenous dexamethasone on interscalene block for pain management after shoulder arthroscopy remains controversial. We conduct this meta-analysis to explore the influence of perineural versus intravenous dexamethasone on interscalene block for pain control after shoulder arthroscopy.
METHODS
We have searched PubMed, Embase, Web of science, EBSCO and Cochrane library databases through April 2021 and included randomized controlled trials (RCTs) assessing the effect of perineural and intravenous dexamethasone on interscalene block in patients with shoulder arthroscopy.
RESULTS
Five RCTs were included in the meta-analysis. Overall, compared with intravenous dexamethasone for shoulder arthroscopy, perineural dexamethasone led to similar block duration (SMD = 0.12; 95% CI - 0.12 to 0.35; P = 0.33), pain scores at 12 h (SMD = - 0.67; 95% CI - 1.48 to 0.15; P = 0.11), pain scores at 24 h (SMD = - 0.33; 95% CI - 0.79 to 0.14; P = 0.17), opioid consumption (SMD = 0.01; 95% CI - 0.18 to 0.19; P = 0.95) and incidence of nausea/vomiting (OR = 0.74; 95% CI 0.38-1.44; P = 0.38).
CONCLUSIONS
Perineural and intravenous dexamethasone demonstrated comparable pain relief after shoulder arthroscopy.
简介
神经周围和静脉内给予地塞米松在经锁骨下肌间沟阻滞用于肩关节镜术后疼痛管理方面的镇痛效果比较仍存在争议。我们进行这项荟萃分析，旨在探讨与静脉内给予地塞米松相比，神经周围给予地塞米松对肩关节镜术后疼痛控制的影响。
方法
我们通过 2021 年 4 月检索了 PubMed、Embase、Web of Science、EBSCO 和 Cochrane 图书馆数据库，并纳入了评估经锁骨下肌间沟阻滞时神经周围和静脉内给予地塞米松对肩关节镜术后患者影响的随机对照试验（RCT）。
结果
共有 5 项 RCT 纳入了荟萃分析。总体而言，与静脉内给予地塞米松相比，神经周围给予地塞米松对肩关节镜术后的阻滞持续时间（SMD=0.12；95%CI-0.12 至 0.35；P=0.33）、12 小时时的疼痛评分（SMD=-0.67；95%CI-1.48 至 0.15；P=0.11）、24 小时时的疼痛评分（SMD=-0.33；95%CI-0.79 至 0.14；P=0.17）、阿片类药物消耗（SMD=0.01；95%CI-0.18 至 0.19；P=0.95）和恶心/呕吐的发生率（OR=0.74；95%CI0.38-1.44；P=0.38）没有差异。
结论
神经周围和静脉内给予地塞米松在肩关节镜术后均能达到相似的镇痛效果。
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