对乙酰氨基酚对小儿术后镇痛效果的Meta分析

A Meta-Analysis of Paracetamol for Postoperative Analgesia in Children

目的评价对乙酰氨基酚对小儿术后镇痛的有效性,为临床提供一定的参考。方法采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆、MEDLINE、Pubmed等外文数据库,以及CNKI数据库、万方数据库、维普数据库等,采用RevMan5.2软件进行Meta分析。结果纳入研究9项,共783例患者,Meta分析显示,对乙酰氨基酚与丁哌卡因镇痛效果在24 h内没有显著差异,且安全性较好。与曲马多相比[95%CI(-0.87,-0.16),P=0.005],疗效虽不及曲马多,但副作用较少;与布洛芬比较,镇痛效果没有明显差异[95%CI(-0.63,0.39),P=0.65];与羟考酮比较,镇痛效果没有明显差异[95%CI(-0.84,5.04),P=0.16]。结论与几种镇痛药相比,对乙酰氨基酚对小儿术后镇痛效果只比曲马多差,且安全性更好。

OBJECTIVE To assess the efficacy of paracetamol in treatment of postoperative analgesia in children. METHODS Randomized controlled trails of paracetamol in treatment of postoperative analgesia in patients were searched in the database of MEDLINE,Cochrane Central Register of Controlled Trials,EMBASE,CNKI,Wanfang database. Data extracted from the literatures were analyzed with the Cochrane Collaboration’s Rev Man 5.1 software. RESULTS A total of 9 reports were identified which met the inclusion criteria. Paracetamol group was similar with bupivacaine group in treating analgesia within 24 h,while with better safety. In comparison with tramadol group,paracetamol group was less effective in treating analgesia [95% CI（- 0. 87,- 0. 16）,P = 0. 005],while the incidence of adverse effect was lower. Paracetamol group was similar with ibuprofen group [95%CI（-0.63,0.39）,P = 0.65]and oxycodone group [95% CI（- 0. 84,5. 04）,P = 0. 16] in treating analgesia. CONCLUSION The efficacy of paracetamol in treating postoperative analgesia in children was similar with bupivacaine,ibuprofen and oxycodone,less effective than tramadol,while with better safety.