帕瑞昔布钠超前镇痛的有效性评价：meta分析

Efficacy of parecoxib sodium for preemptive analgesia： a meta-analysis

目的采用meta分析方法评价帕瑞昔布钠用于超前镇痛的有效性。方法检索PubMed、Embase、Cochrane数据库和CNKI数据库，不限定发表时间和语言。收集帕瑞昔布钠应用于超前镇痛的随机安慰剂对照研究。采用改良Jadad法评价文献质量。以术后1、6、12和24h时视觉模拟评分（VAS评分）、术后24h内吗啡用量、术后恶心呕吐发生情况为评价指标。采用RevMan5．0．2软件进行meta分析。结果纳入14项研究，Jadad评分均≥4分，包括1086例患者。分为安慰剂组和术前静脉注射帕瑞昔布钠40mg组。Meta分析结果显示：与安慰剂组比较，术前静脉注射帕瑞昔布钠40mg组术后1、6、12和24h时VAS评分降低，术后24h内吗啡用量减少，术后恶心呕吐发生率降低（P〈0．05）。结论术前静脉注射帕瑞昔布钠40mg可产生显著的超前镇痛效果，有助于降低术后镇痛的不良反应。

Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia. Methods PubMed, EMBASE, Cochrane Library, and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia. The modified Jadad scale was used for quality assessment. Evaluation indexes included VAS scores at 1, 6, 12 and 24 h after operation, consumption of mor- phine within 24 h after operation, and incidences of nausea and vomiting after operation. Meta-analysis was con- ducted using the Cochrane Collaboration＇s RevMan 5.0.2 software. Results Fourteen randomized placebo-con- trolled trials involving 1086 patients were included in our meta-analysis. The modified Jadad scale scores for the 14 studies were ≥ 4. The patients were divided into 2 groups： placebo group and pareeoxib sodium 40 mg injected be- fore operation group. The results of meta-analysis showed that VAS scores at 1, 6, 12 and 24 h after operation were significantly decreased, the consumption of morphine within 24 h after operation was reduced, and the inci- dences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group （ P 〈 0. 05）. Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.