骨科患者围手术期疼痛管理的最佳证据总结

Summary of the best evidence for perioperative pain management in orthopedic patients

目的检索骨科患者围手术期疼痛管理的最佳证据。方法依据“6S”证据模型,自上而下检索Up To Date、BMJ最佳临床实践、澳大利亚JBI循证卫生保健中心数据库、Cochrane Library、英国国家临床评价研究所、苏格兰校际指南网、国际网络指南网、医脉通、PubMed、EMbase、中国生物医学文献数据库、中国知网和万方数据库中与骨科患者围手术期疼痛管理相关的证据,包括临床决策、指南、证据总结、系统评价、专家共识及相关原始研究。检索时限为建库至2020年6月23日。两名研究人员独立进行文献质量评价,并结合专业人士的判断,提取和总结符合标准的文献证据。结果共纳入10篇文献,包括临床决策2篇、指南2篇、系统评价5篇、专家共识1篇。最终从疼痛管理原则、疼痛评价、术前疼痛管理、术中疼痛管理、术后疼痛管理、延续性疼痛管理6个方面总结了45条最佳证据。结论研究总结的骨科患者围手术期疼痛管理的最佳证据可为医护人员提供循证依据。

Objective To retrieve the best evidence for perioperative pain management in orthopedics patients.Methods According to the"6S"evidence model,a top-down search of Up To Date,BMJ best clinical practice,Joanna Briggs Institute(JBI),Cochrane Library,National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guideline Network(SIGN),Guidelines International Network(GIN),China Medical Pulse Guide Network,PubMed,Embase,China Biomedical Literature Database(CBM),China Knowledge Network(CNKI),and Wanfang database on the relevant evidence on the perioperative pain management of orthopedic patients that included the highest clinical decision support,guidelines,evidence summary,systematic reviews,expert consensus,expert advice and related original research.The search time limit was from the establishment of the database to June 23,2020.Two researchers conducted independent evaluations of the literature,and combined the judgments of professionals to extracted and summarized documents that meet the standards.Results A total of 10 articles were included,including 2 clinical decision support articles,2 guidelines,5 systematic reviews and 1 expert consensus.Finally,45 best evidences were summarized from 6 aspects of pain management principles,pain evaluation,preoperative pain management,intraoperative pain management,postoperative pain management and continuous pain management.Conclusion The best evidence for perioperative pain management in orthopedic patients are summarized in the study can provide evidence-based evidence supports for medical staff.