超前镇痛是腰椎手术后缓解疼痛的一个好选择吗？：一项对随机对照试验进行的Meta分析
一项对随机对照试验进行的Meta分析
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超前镇痛是腰椎手术后缓解疼痛的一个好选择吗？：一项对随机对照试验进行的Meta分析
贵州医科大学 高鸿教授课题组
翻译：潘志军 修改：佟睿 编辑：佟睿 审校：曹莹
腰椎手术术后可发生中度至重度疼痛。术后恰当的疼痛处理有助于康复。最近，在减少术后疼痛的重要镇痛方法中，超前镇痛已被认为是重要的镇痛方法之一。但是，其在腰椎手术后缓解疼痛方面的功效尚不清楚。这项研究旨在评估超前镇痛对腰椎手术的效果。
我们在PubMed（1996年至2020年5月），Embase（1980年至2020年5月）和Cochrane图书馆（CENTRAL，2020年5月）中搜索了随机对照试验。我们纳入了七项评估超前镇痛在腰椎手术中的镇痛效果的研究。
七项研究（共纳入509例患者）符合纳入标准。汇总数据显示，就视觉模拟量表评分（P <0.05），吗啡当量总消耗量（P <0.05）和住院时间（P <0.05）而言，超前镇痛对腰椎手术有效，而无并发症增加（P = 0.73）。
我们的研究结果表明，超前镇痛对腰椎手术安全有效。
CIs =置信区间，LOS =住院时间，MD =均差，OR =奇数比，PRISMA =用于系统评价和Meta分析的首选报告项目，RCT =随机对照试验，VAS =视觉模拟量表。
原始文献来源：
Lu-kai Zhang, Qiang Li, Ren-Fu Quan, et al. Is preemptive analgesia a good choice for postoperative pain relief in lumbar spine surgeries?: A meta-analysis of randomized controlled trials.[J].Medicine(Baltimore)2021; 100(13).
Is preemptive analgesia a good choice for postoperative pain relief in lumbar spine surgeries?: A meta-analysis of randomized controlled trials
Background: Lumbar spine surgery is associated with moderate-to-severe postoperative pain. Adequate pain management during the postoperative period facilitates rehabilitation. Recently, preemptive analgesia has been considered among the important analgesic methods for reducing postoperative pain. However, its efficacy in postoperative pain relief after lumbar spine surgery remains unclear. This study aimed to evaluate the effects of preemptive analgesia on lumbar spine surgery.
Methods: We searched for randomized controlled trials in PubMed (1996 to May 2020), Embase (1980 to May 2020), and Cochrane Library (CENTRAL, May 2020). We included seven studies that evaluated the preemptive analgesic efficacy in lumbar spine surgeries.
Results: Seven studies, including 509 patients, met the inclusion criteria. Pooled data revealed that preemptive analgesia is effective for lumbar spine surgeries with respect to the visual analog scale score (P < .05), total morphine equivalent consumption (P < .05), and length of stay (P<.05), without increasing complications (P=.73).
Conclusions: Our findings indicate that preemptive analgesia is safe and effective for lumbar spine surgery. Abbreviations: CIs = confidence intervals, LOS = length of hospital stay, MD = mean difference, OR = odd ratio, PRISMA =preferred reporting items for systematic review and meta-analyses, RCT = randomized controlled trial, VAS = visual analog scale.
Keywords: analgesia, lumbar spine surgery, morphine consumption, preemptive, visual analog scale
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