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引用本文:郑蓓,李功华,郑璐璐,朱珺,曾深,梁冰清,李晶晶,杨文娟,辛传伟,张美玲.单剂量酮咯酸用于围术期超前镇痛的meta分析[J].中国现代应用药学,2019,36(9):1107-1114.
ZHENG Bei,LI Gonghua,ZHENG Lulu,ZHU Jun,ZENG Shen,LIANG Bingqing,LI Jingjing,YANG Wenjuan,XIN Chuanwei,ZHANG Meiling.Meta-analysis of Single Dose Ketorolac on Preemptive Analgesia in Perioperative Period[J].Chin J Mod Appl Pharm(中国现代应用药学),2019,36(9):1107-1114.
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单剂量酮咯酸用于围术期超前镇痛的meta分析
郑蓓, 李功华, 郑璐璐, 朱珺, 曾深, 梁冰清, 李晶晶, 杨文娟, 辛传伟, 张美玲
浙江省立同德医院药学部, 杭州 310012
摘要:
目的 采用meta分析综合评价单剂量酮咯酸用于围术期超前镇痛的有效性及安全性。方法 遵循PRISMA声明指南,全面检索公开发表的随机对照试验,通过meta分析综合评价单剂量全身酮咯酸对术后疼痛、阿片样药物消耗及不良反应的影响。结果 共纳入11项研究,累计606人。Meta分析结果表明术后0,4,8 h的酮咯酸超前镇痛效果明显,术后24 h的酮咯酸超前镇痛效果无统计学差异。酮咯酸超前镇痛可以减少术后阿片类药物(吗啡)的使用[MD=-4.25,95%CI (-8.16,-0.35),P=0.03],减少恶心、呕吐不良反应的发生[RR=0.68,95%CI (0.51,0.90),P=0.006],且未增加严重不良反应。结论 现有的临床文献数据表明,酮咯酸用于围手术期超前镇痛效果明确,可减少术后阿片类药物(吗啡)的使用量,同时减少了恶心或呕吐的发生。
关键词:  酮咯酸  围手术期  超前镇痛  meta分析
DOI:10.13748/j.cnki.issn1007-7693.2019.09.016
分类号:R969.4
基金项目:2017年浙江省医坛新秀计划项目;浙江省立同德医院111人才项目(2D01703)
Meta-analysis of Single Dose Ketorolac on Preemptive Analgesia in Perioperative Period
ZHENG Bei, LI Gonghua, ZHENG Lulu, ZHU Jun, ZENG Shen, LIANG Bingqing, LI Jingjing, YANG Wenjuan, XIN Chuanwei, ZHANG Meiling
Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
Abstract:
OBJECTIVE To evaluate the efficacy and security of a single dose of perioperative ketorolac on postoperative analgesia by meta-analysis. METHODS Followed the PRISMA statement guidelines. A wide search was performed to identify randomized controlled trials that evaluated the effects of a single dose of systemic ketorolac on postoperative pain, opioid consumption and adverse reactions. Meta analysis was performed using a random-effects model. RESULTS Eleven randomized clinical trials with 606 subjects were included. The result showed statistically differences for ketorolac over placebo for 0, 4, and 8 h after surgery, but not at 24 h. Preemptive analgesia with ketorolac could reduce the use of postoperative opioids(morphine)[MD=-4.25, 95%CI(-8.16, -0.35), P=0.03]. Postoperative nausea and vomiting were decreased by ketorolac, with an RR sratio (95%CI) of 0.68 (0.51, 0.90) (P=0.006), and did not increase the occurrence of serious adverse reactions. CONCLUSION The available clinical studys indicate that ketorolac is effective for perioperative advanced analgesia and can reduce postoperative opioid(morphine) usage and also decrease nausea or vomiting.
Key words:  ketorolac  perioperative  preemptive analgesia  meta analysis
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