盐酸曲马多联合舒芬太尼术后静脉自控镇痛随机对照试验的meta分析

Tramadol hydrochloride combined with sufentanil for patient-controlled intravenous analgesia:A Meta-analysis of randomized controlled trial

目的评价曲马多联合舒芬太尼术后静脉自控镇痛(PCIA)的临床效果与安全性。方法电子检索PubMed、Embase、Cochrane图书馆、CNKI、VIP等数据库,收集曲马多联合舒芬太尼术后PCIA的临床研究文献,采用RevMan 5.2软件进行meta分析。结果共纳入6个随机对照试验(RCT),共324例患者,meta分析结果显示:①疼痛视觉模拟VAS评分:曲马多联合舒芬太尼组与单用舒芬太尼组术后4、8、12、24、36、48 h评分差异均无统计学意义。②镇静评分:与对照组相比,曲马多联合舒芬太尼组术后24 h镇静(Ramsay)评分降低[WMD=-0.24,95%CI(-0.35,-0.13),P<0.01],但术后4、8、12、36、48 h评分结果显示两组差异无统计学意义。③安全性:两组不良反应的发生率差异无统计学意义。结论曲马多联合舒芬太尼与单用舒芬太尼组术后PCA均能获得满意的镇痛效果。

[ Objective ] To evaluate the efficacy and safety of tramadol hydrochloride combined with sufentanil for patient-controlled intravenous analgesia （PCIA）. [ Methods] The randomized controlled trials of tramadol hydrochloride combined with sufentanil for PCIA were gathered from PubMed, Embase, and Cochrane database of Systematic Reviews, CNKI and VIP. The data analyses were performed with software RevMan 5.2. [ Results ] Totally 6 RCTs were included, with 324 cases, the results of meta-aaalyses showed： ① as for visual analog scale （VAS） score, there were no significant differences at 4-hour, 8-hour, 12-hour, 24-hour, 36-hour and 48-hour between the 2 groups. ② Sedation Scale ： compared with the control group, the Ramsay score of post-operation at 24-hour [ WMD = - 0.24,95% CI（ -0. 35 to- 0. 13 }, P 〈 0.01 ] was decreased in sufentanfl combined with tramadol hydrochloride group, but there was no significant difference in VAS of post-operation at 4-hour, 8-hour, 12-hour, 36-hour and 48-hour between the 2 groups. ③ Adverse reaction ： there was no significant difference in incidence of adverse reactions between the 2 groups. [ Conclusion] Tramadol hydrochloride combined with sufentanil or sufentanil alone can obtain satisfactory effect of analgesia for PCIA after operation.