氯诺昔康超前镇痛的术后镇痛效果和安全性Meta分析

Effect and safety of preemptive analgesia with lornoxicam on postoperative analgesia, a Meta-analysis

目的 通过对随机对照实验的数据进行Meta分析,系统评价氯诺昔康超前镇痛对术后镇痛的效果和安全性.方法 检索PubMed、Embase、Cochrane Library、CNKI、万方数据知识服务平台和中国知网等文献数据库,查找氯诺昔康超前镇痛对术后镇痛的效果和安全性的随机对照实验,并由两位研究人员对资料进行筛选与评价,使用RevMan5.3软件对结果进行Meta分析. 结果 共纳入4个随机对照实验.实验组术前静脉注射氯诺昔康,对照组使用安慰剂.Meta分析结果显示,患者术后VAS评分在各时间点情况分别为：术后4h,均数差（mean deviation,MD）=-1.58,95％置信区间（confidence interval,CI）为-2.38～-0.77 （P＜0.01）;术后8h,MD=-1.43,95％CI为-2.09～--0.77 （P＜0.01）;术后12h,MD=-1.35,95％CI为1.72～-0.98 （P＜0.01）;术后24h,MD=-1.02,95％CI为-1.29～-0.76（P＜0.01）.副作用发生情况：相对危险度（relative risk,RR）=1,95％CI为0.47～2.12（P=1）. 结论 鉴于现有研究结果,氯诺昔康超前镇痛对术后4、8、12、24h患者具有镇痛效果,结果具有统计学意义,氯诺昔康超前镇痛产生副作用情况尚不明朗.

Objective To evaluate the effect and safty of preemptive analgesia with lornoxicam on postoperative analgesia.Methods We searched PubMed,Embase,Cochrane Library,CNKI,Articles and HowNet and other literature database for lornoxicam preemptive analgesia on postoperative analgesic efficacy and safety of randomized controlled trials.All of the data were screened and evaluated by two researchers.RevMan5.3 was applied to perform Meta-analysis.Results A total of four randomized controlled trials were qualified for Meta-analysis.Lornoxicam was given intravenously in the experiment group,and the control group received placebo.Meta-analysis showed that VAS scores at each time point were that：4 h,mean deviation （MD）=-1.58,95% confidence interval（CI）：（-2.38,-0.77）（P=0.000 1）,8 h,MD=-1.43,95%CI：（-2.09,-0.77）（P〈0.000 1）,12 h,MD=-1.35,95%CI：（-1.72,-0.98）（P〈0.000 01）,24 h,MD=-1.02,95%CI：（-1.29,-0.76）（P〈0.000 01）.Adverse reaction case was [relative risk （RR）=1,95%CI：（0.47,2.12）（P=1）].Conclusions In view of the existing research results,lomoxicam preemptive analgesia have an analgesic effect in patients on 4,8,12,24 h after surgery.However,adverse reactions of preemptive analgesia with lomoxicam has not been clear yet.