心脏术后患者疼痛管理的最佳证据总结

Summary of the best evidence for pain management in patients after cardiac surgery

目的 检索、评价并总结心脏术后患者疼痛管理的最佳证据。方法 系统检索BMJ Best Practice、UpToDate、美国指南网、国际指南网、英国国家卫生与临床优化研究所、加拿大安大略医学会、苏格兰院际间指南网、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、Cochrane Library、PubMed、Web of Science、中国知网、万方数据库和中国生物医学文献数据库关于心脏术后患者疼痛管理的所有证据,包括指南、系统评价、证据总结、专家共识及相关原始研究。检索时限为建库至2022年6月。采用JBI循证卫生保健中心的文献评价标准和证据分级系统进行文献质量评价及证据级别判定。结果 共纳入11篇文献,其中指南2篇、专家共识4篇、系统评价4篇、随机对照试验1篇。最终从疼痛管理原则、疼痛评估、药物止痛策略、非药物止痛策略共4个方面总结出23条最佳证据。结论 本研究总结了心脏术后患者疼痛管理的最佳证据,可为该类患者术后疼痛管理提供循证依据。

Objective To retrieve,evaluate,and summarize the best evidence on pain management in patients after cardiac surgery.Methods Systematic searches were conducted on data on pain management in patients after cardiac surgery of BMJ Best Practice,UpToDate,USGuidesnet,USGuidesnet International,UK National Institute for Health and Clinical Excellence,Ontario Medical Association of Canada,Scottish Interhospital Guidesnet,Joanna Briggs Institute(JBI)database of Evidence-Based Health care centres,Cochrane Library,PubMed,Web of Science,China National Knowledge Infrastructure,Wanfang Database and China Biomedical Literature Database,including guidelines,systematic reviews,summaries of evidence,expert consensus,and related original studies.The search period was from the establishment of the database to June 2022.The quality of literature and the level of evidence were evaluated by the evaluation criteria and evidence grading system of JBI evidence-based health care center.Results A total of 11 literatures were included,including 2 guidelines,4 expert consensus,4 systematic reviews and 1 randomized controlled trial.Finally,23 pieces of best evidence were summarized from four aspects:pain management principles,pain evaluation,drug analgesic strategies and non-drug analgesic strategies.Conclusion This study summarizes the best evidence for pain management in patients after cardiac surgery,and provides evidence-based evidence for pain management in these patients.