地佐辛用于手术超前镇痛有效性和安全性的Meta分析

Efficacy and safety of Dezocine in preemptive analgesia:a Meta-analysis

目的采用Meta分析的方法评价地佐辛用于手术前超前镇痛的临床有效性和安全性。方法计算机检索PubMed,EMbase,Cochrane Library,维普,中国知网,万方数据库中从建库至2012年12月间发表的随机对照试验,对符合纳入标准的研究在资料提取和文献质量评价后,采用RevMan 5.1软件进行Meta分析。结果纳入9个文献共计480例患者,均为中文。Meta分析结果显示:与对照组比较,地佐辛超前镇痛能有效减轻患者术后疼痛,术后1、2、12、24 h的VAS评分差异均有统计学意义[均数差(95%CI)分别为-1.27(-1.67～-0.87)、-0.91(-1.14～-0.68)、-0.71(-1.13～-0.29)、-0.74(-0.95～-0.54)];地佐辛能够显著降低术后发生总的不良反应发生率[OR=0.51,95%CI(0.31～0.90,P=0.02)。结论当前证据表明,地佐辛用于手术超前镇痛效果好,不良反应发生率低。但鉴于纳入研究较少且样本量小,特别是质量不高,故仍需开展大样本、多中心、高质量的随机对照试验进一步论证。

Objective To evaluate the preemptive analgesia effect and safety of Dezocine by a Meta-analysis. Meth- ods Using the search terms ＂Dezocine, preemptive analgesia, randomized controlled trials, Meta-analysis＂, Trials were collected through searches of PubMed, EMbase, the Cochrane Library, VIP, CNKI, and Wanfang databases. From the date of establishment of the databases to December 2012 for randomized controlled trials about the efficacy and safety of Dezocine in preemptive analgesia. The included studies were evaluated with criteria and the extracted data were an- alyzed by Rev-Man 5.1. Results Nine studies, involving 480 patients, met the inclusion criteria. Compared with con- trolled group, Dezocine preemptive analgesia could obviously reduce postoperative pain and has statistical significance for preemptive analgesia at the end of 1, 2, 12, 24 h of operation based on the VAS ratings with MD （95%C/） were that：-1.27 [（-1.67） - （-0.87）], -0.91 [（-1.14） - （-0.68）],-0.71 [（-1.13） - （-0.29）], -0.74 [（-0.95）-（-0.54）]; Dezocine also could decrease the occurrence risk of postoperative side effects [OR = 0.51, 95%CI （0.31-0.90）, P = 0.02]. Con- clusion The limited current evidence shows that Dezocine can reduce postoperative pain effectively, and has fewer side effects, which is beneficial for the preemptive analgesia. However, due to the few included RCTs and small samples, es- pecially for the lower quality of included RCTs, more large-sample, high-quality RCTs are required for further verify.