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腹部手术后针灸的阿片类药物节省效应:一项系统评价和Meta分析方案

The Opioid-Sparing Effect of Acupuncture After Abdominal Surgery: A Systematic Review and Meta-Analysis Protocol.

作者信息

Joo Chanwoo, Kim Kun Hyung, Jang Bo-Hyoung, Huang Ching-Wen, Kang Jung Won, Lee Jae-Dong, Lee Suji, Lee Seunghoon

机构信息

Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.

Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea.

出版信息

J Pain Res. 2023 Mar 29;16:1095-1101. doi: 10.2147/JPR.S395672. eCollection 2023.

Abstract

PURPOSE

Routine overprescribing of postoperative opioid analgesics may induce side effects and correlate with chronic opioid use following surgery. This review aims to evaluate the effectiveness and safety of acupuncture for opioid-sparing effects in patients who underwent abdominal surgery.

METHODS

Eleven databases in different languages, including English (Ovid MEDLINE, CENTRAL, EMBASE, CINAHL), Chinese, Korean, and Japanese, will be searched. Randomized controlled trials using acupuncture for postoperative pain control in adult patients undergoing abdominal surgery will be screened. All randomized controlled trials comparing acupuncture with no treatment, sham acupuncture, and conventional treatments will be included. The Cochrane risk of bias tool will be used to assess the risk of bias. The primary outcome will consist of a cumulative opioid consumption. Additionally, the number of cumulative opioid analgesic demands/requests, the time to initial opioid analgesic usage, postoperative pain, opioid-related side effects, and adverse events of acupuncture will be assessed. The mean differences or risk ratios with a 95% confidence interval will be calculated to estimate the pooled effect of acupuncture when it is possible to conduct a meta-analysis.

RESULTS

This study could confirm the effect of opioid-sparing on acupuncture after abdominal surgery.

CONCLUSION

This study would evaluate the evidence on the effectiveness of acupuncture after abdominal surgery with a focus on opioid intake. It provides evidence to support decision-making on applying acupuncture for postoperative management.

REGISTRATION NUMBER

CRD42022311155.

摘要

目的

术后阿片类镇痛药的常规过度处方可能会引发副作用,并与术后慢性阿片类药物使用相关。本综述旨在评估针刺对腹部手术患者阿片类药物节省效应的有效性和安全性。

方法

将检索11种不同语言的数据库,包括英文(Ovid MEDLINE、CENTRAL、EMBASE、CINAHL)、中文、韩文和日文。将筛选使用针刺控制成年腹部手术患者术后疼痛的随机对照试验。所有比较针刺与不治疗、假针刺和传统治疗的随机对照试验都将纳入。将使用Cochrane偏倚风险工具评估偏倚风险。主要结局将包括阿片类药物的累积消耗量。此外,还将评估阿片类镇痛药累积需求/请求的次数、首次使用阿片类镇痛药的时间、术后疼痛、阿片类药物相关副作用以及针刺的不良事件。当有可能进行荟萃分析时,将计算95%置信区间的平均差或风险比,以估计针刺的合并效应。

结果

本研究可以证实针刺对腹部手术后阿片类药物节省的作用。

结论

本研究将评估腹部手术后针刺有效性的证据,重点关注阿片类药物的摄入量。它为针刺应用于术后管理的决策提供了支持证据。

注册号

CRD42022311155。

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