Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a ...Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a recommended solution,where oxycodone has depicted unique advantages in recent years.However,controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA.Methods:We performed a literature search in PubMed,Embase,the Cochrane Central Register of Controlled Trials,Web of Science,Chinese National Knowledge Infrastructure,Wanfang,and VIP databases up to December 2020 to select specific randomized controlled trials(RCTs)comparing the efficacy of oxycodone with sufentanil in PCIA.The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption,the Ramsay sedation scale,patients’satisfaction and side effects.Results:Fifteen RCTs were included in the meta-analysis.Compared with sufentanil,oxycodone showed lower Numerical Rating Scale scores(mean difference[MD]=-0.71,95%confidence interval[CI]:-1.01 to-0.41;P<0.001;I^(2)=93%),demonstrated better relief from visceral pain(MD=-1.22,95%CI:-1.58 to-0.85;P<0.001;I^(2)=90%),promoted a deeper sedative level as confirmed by the Ramsay Score(MD=0.77,95%CI:0.35-1.19;P<0.001;I^(2)=97%),and resulted in fewer side effects(odds ratio[OR]=0.46,95%CI:0.35-0.60;P<0.001;I^(2)=11%).There was no statistical difference in the degree of patients'satisfaction(OR=1.13,95%CI:0.88-1.44;P=0.33;I^(2)=72%)and drug consumption(MD=-5.55,95%CI:-14.18 to 3.08;P=0.21;I^(2)=93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects,and could be recommended for PCIA,especially after abdominal surgeries.Registration:PROSPERO;https://www.crd.york.ac.uk/PROSPERO/;CRD42021229973.展开更多
目的比较舒芬太尼复合地佐辛或氟比洛芬酯在剖宫产手术术后镇痛中的效果。方法挑选择期行剖宫产手术的患者150例,使用随机数字表法分为3组,术后镇痛均为PCIA。镇痛配方为舒芬太尼100μg+地佐辛15mg(A组),舒芬太尼100μg+氟比洛芬酯150 m...目的比较舒芬太尼复合地佐辛或氟比洛芬酯在剖宫产手术术后镇痛中的效果。方法挑选择期行剖宫产手术的患者150例,使用随机数字表法分为3组,术后镇痛均为PCIA。镇痛配方为舒芬太尼100μg+地佐辛15mg(A组),舒芬太尼100μg+氟比洛芬酯150 mg(B组)以及地佐辛15 mg+氟比洛芬酯150 mg(C组)。三组均加入阿扎司琼10 mg,并且用生理盐水稀释到100 m L。初始剂量2 m L,背景剂量2 m L/h,PCA剂量2 m L,锁定时间30min。分别记录患者于术后2、4、8、24 h的VAS疼痛评分以及术后24 h内PCA次数和不良反应。结果术后2、4、8 h,A组的VAS评分以及24 h内PCA次数均明显低于B、C组(P<0.05)。术后24 h内A组患者的不良反应发生明显低于B、C组(P<0.05)。结论舒芬太尼复合地佐辛可以安全有效地用于剖宫产手术术后的镇痛。展开更多
目的:探讨影响术后恶心呕吐(postoperative nausea and vomiting,PONV)发生的因素,为临床优选个体化患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)止吐方案提供参考。方法:随访北京积水潭医院468例骨科术后患者,分...目的:探讨影响术后恶心呕吐(postoperative nausea and vomiting,PONV)发生的因素,为临床优选个体化患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)止吐方案提供参考。方法:随访北京积水潭医院468例骨科术后患者,分析患者年龄、性别、体质指数(body mass index,BMI)、美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级、吸烟史、晕动病史、术后恶心呕吐(post operative nausea and vomiting,PONV)史、手术部位、手术时间、麻醉方式以及静脉镇痛泵使用情况11个因素对PONV发生率的影响。结果:单因素分析结果显示性别、吸烟史、晕动病史、PONV史、手术部位以及静脉镇痛泵使用情况与PONV的发生相关。多因素logistic回归分析显示女性(OR=2.49,95%CI:1.37~4.53)、有PONV史(OR=4.44,95%CI:1.82~10.82)、有晕动病史(OR=2.05,95%CI:1.22~3.43)和使用静脉镇痛泵(OR=2.24,95%CI:1.14~4.41)是PONV的危险因素。结论:临床在选择患者PCIA止吐方案及评估PONV时,需综合考虑患者性别、PONV史、晕动病史和静脉镇痛泵使用情况。展开更多
文摘Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a recommended solution,where oxycodone has depicted unique advantages in recent years.However,controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA.Methods:We performed a literature search in PubMed,Embase,the Cochrane Central Register of Controlled Trials,Web of Science,Chinese National Knowledge Infrastructure,Wanfang,and VIP databases up to December 2020 to select specific randomized controlled trials(RCTs)comparing the efficacy of oxycodone with sufentanil in PCIA.The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption,the Ramsay sedation scale,patients’satisfaction and side effects.Results:Fifteen RCTs were included in the meta-analysis.Compared with sufentanil,oxycodone showed lower Numerical Rating Scale scores(mean difference[MD]=-0.71,95%confidence interval[CI]:-1.01 to-0.41;P<0.001;I^(2)=93%),demonstrated better relief from visceral pain(MD=-1.22,95%CI:-1.58 to-0.85;P<0.001;I^(2)=90%),promoted a deeper sedative level as confirmed by the Ramsay Score(MD=0.77,95%CI:0.35-1.19;P<0.001;I^(2)=97%),and resulted in fewer side effects(odds ratio[OR]=0.46,95%CI:0.35-0.60;P<0.001;I^(2)=11%).There was no statistical difference in the degree of patients'satisfaction(OR=1.13,95%CI:0.88-1.44;P=0.33;I^(2)=72%)and drug consumption(MD=-5.55,95%CI:-14.18 to 3.08;P=0.21;I^(2)=93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects,and could be recommended for PCIA,especially after abdominal surgeries.Registration:PROSPERO;https://www.crd.york.ac.uk/PROSPERO/;CRD42021229973.
文摘目的比较舒芬太尼复合地佐辛或氟比洛芬酯在剖宫产手术术后镇痛中的效果。方法挑选择期行剖宫产手术的患者150例,使用随机数字表法分为3组,术后镇痛均为PCIA。镇痛配方为舒芬太尼100μg+地佐辛15mg(A组),舒芬太尼100μg+氟比洛芬酯150 mg(B组)以及地佐辛15 mg+氟比洛芬酯150 mg(C组)。三组均加入阿扎司琼10 mg,并且用生理盐水稀释到100 m L。初始剂量2 m L,背景剂量2 m L/h,PCA剂量2 m L,锁定时间30min。分别记录患者于术后2、4、8、24 h的VAS疼痛评分以及术后24 h内PCA次数和不良反应。结果术后2、4、8 h,A组的VAS评分以及24 h内PCA次数均明显低于B、C组(P<0.05)。术后24 h内A组患者的不良反应发生明显低于B、C组(P<0.05)。结论舒芬太尼复合地佐辛可以安全有效地用于剖宫产手术术后的镇痛。
文摘目的:探讨影响术后恶心呕吐(postoperative nausea and vomiting,PONV)发生的因素,为临床优选个体化患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)止吐方案提供参考。方法:随访北京积水潭医院468例骨科术后患者,分析患者年龄、性别、体质指数(body mass index,BMI)、美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级、吸烟史、晕动病史、术后恶心呕吐(post operative nausea and vomiting,PONV)史、手术部位、手术时间、麻醉方式以及静脉镇痛泵使用情况11个因素对PONV发生率的影响。结果:单因素分析结果显示性别、吸烟史、晕动病史、PONV史、手术部位以及静脉镇痛泵使用情况与PONV的发生相关。多因素logistic回归分析显示女性(OR=2.49,95%CI:1.37~4.53)、有PONV史(OR=4.44,95%CI:1.82~10.82)、有晕动病史(OR=2.05,95%CI:1.22~3.43)和使用静脉镇痛泵(OR=2.24,95%CI:1.14~4.41)是PONV的危险因素。结论:临床在选择患者PCIA止吐方案及评估PONV时,需综合考虑患者性别、PONV史、晕动病史和静脉镇痛泵使用情况。
