布洛芬超前镇痛缓解下颌第三磨牙拔除术后疼痛的系统评价与meta分析

Systematic evaluation and meta analysis of Ibuprofen’s preemptive analgesia in relieving pain after mandibular third molar extraction

目的:研究口服布洛芬用于超前镇痛对缓解第三磨牙手术后疼痛的有效性。方法:检索PubMed、EMBASE、Web of Sci、CNKI和万方数据库1984年1月~2023年3月发表的有关口服布洛芬用于下颌第三磨牙拔除超前镇痛的中英文文献。使用RevMan5.4.1软件进行meta分析评价其对术后缓解疼痛有效性和术后镇痛药物的使用情况。结果:共纳入8篇文献,共计549例下颌第三磨牙拔除,均为单中心的随机对照临床研究。口服布洛芬用于超前镇痛,术前口服布洛芬能够降低术后1 h[MD=-1.73,95%CI(-2.30,-1.16)]及术后4 h[MD=-2.27,95%CI(-2.82,-1.71)]的疼痛评分。纳入的文献分析结果表明,术前口服布洛芬无法得出减轻术后24 h镇痛药物的使用[MD=-1.18,95%CI(-3.33,0.97)]。结论:口服布洛芬超前镇痛能有效降低拔牙术后4 h内的平均疼痛评分。术前口服布洛芬无法得出减轻术后24 h镇痛药物的使用的结论。

Objective:To study the effectiveness of oral Ibuprofen’s preemptive analgesia on relieving pain after third molar operation.Methods:Databases including PubMed,EMBASE,Web of Sci,CNKI and Wanfang Database were sys-tematically searched from Jan 1984 until Mar 2023,and literature search was conducted on Chinese and English databases to screen the relevant literature of oral Ibuprofen for preemptive analgesia of mandibular third molar extraction,to evaluate the relevant studies on the effectiveness of postoperative pain relief,and to conduct quantitative and qualitative analysis on the included research results.Results:A total of 549 cases of mandibular third molar extraction were included in 8 literatures,all of which were single center randomized controlled clinical studies.Oral Ibuprofen was used for preemptive analgesia.Oral Ibuprofen for preemptive analgesia can reduce the mean pain score at 1 hour after operation[MD=-1.73,95%CI(-2.30,-1.16)],and 4 hours after operation[MD=-2.27,95%CI(-2.82,-1.71)].In addition,the results of literature analysis included in this study showed that oral Ibuprofen before operation could not reduce the use of analgesic drugs 24 hours after operation[MD=-1.18,95%CI(-3.33,0.97)].Conclusion:Oral Ibuprofen preemptive analgesia effectively reduced the average pain score within 4 hours after tooth extraction.Preoperative oral Ibuprofen did not reduce the use of analgesics 24 hours after surgery.