[罂粟摘要]吗啡与舒芬太尼用于术后疼痛管理的比较：一项meta分析

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吗啡与舒芬太尼用于术后疼痛管理的比较：一项meta分析

贵州医科大学  麻醉与心脏电生理课题

翻译:  严旭

编辑:  严旭

审校: 曹莹

背景：控制镇痛（PCA）是治疗术后疼痛的有效方法。许多研究也将吗啡的疗效与舒芬太尼进行了比较。本系统审查的目的是比较吗啡和舒芬太尼的疗效和安全性。

方法：搜索了七个数据库进行对照试验，以比较吗啡和舒芬太尼的疗效和安全性。在选择研究、提取数据和评估研究质量后，使用RevMan 5.3对几项研究进行了meta分析。

结果：13项研究共纳入了812名患者。12小时，吗啡组的疼痛强度明显低于舒芬太尼组。24至48小时没有统计差异（MD12 = -1.52，95% CI [-2.13, -1.97]，P <.05）。吗啡组在12、24和48小时的镇静强度低于舒芬太尼组，差异没有统计学意义（MD12 = -0.03，95% CI [-0.18, 0.12]，P > .05；MD24 = -0.20，95% CI [-0.42, 0.03]，P > .05；MD48 = -0.03，95% CI [-0.18, 0.11）]，P > .05）。吗啡组中的PCA需求小于舒芬太尼组，差异没有统计学意义（RR = -0.20，95% CI [-1.93,1.53]，P > .05）。吗啡组不良事件的发生率低于舒芬太尼组，并且存在统计学差异（RR = 0.61，95% CI [0.47,0.79]，P < .05）。

结论：与舒芬太尼相比，吗啡在缓解疼痛和术后12小时、24小时和48小时的PCA需求方面更有效，并显著降低了不良事件的发生率，但在镇静强度方面没有优势。

原始文献来源：

Zhong-Biao Nie 1, Zhi-Hong Li 1, Bin Lu 2, Y,Hydromorphone vs sufentanil in patient-controlled analgesia for postoperative pain management: A meta-analysis,Medicine (Baltimore). 2022Jan21;101(3):e28615.doi:10.1097/MD.0000000000028615.

英文原文：

Hydromorphone vs sufentanil in patient-controlled analgesia for postoperative pain management: A meta-analysis

Background: Patient-controlled analgesia (PCA) is an effective method of postoperative pain, there have been many studies performed that have compared the efficacy of hydromorphone with continuous sufentanil. The purpose of this systematic review is to compare the efficacy and safety of hydromorphone and sufentanil.

Methods: Seven databases were searched for controlled trials to compare the efficacy and safety of hydromorphone and sufentanil. After selecting the studies, extracting the data, and assessing study quality, the meta-analysis was performed on several of the studies with RevMan 5.3.

Results: Thirteen studies comprised of 812 patients were found. The pain intensity of the hydromorphone group was significantly lower than that of the sufentanil group at 12 hours. With no statistical difference at 24 to 48 hours (MD12 = -1.52, 95% CI [-2.13, -1.97], P <.05). The sedation intensity of the hydromorphone group at 12, 24, and 48 hours were lower than those of the sufentanil group, with no statistical difference (MD12 = -0.03, 95% CI [-0.18, 0.12], P > .05; MD24 = -0.20, 95% CI [-0.42, 0.03], P > .05; MD48 = -0.03, 95% CI [-0.18, 0.11)], P > .05). The PCA requests in the hydromorphone group were less than that in the sufentanil group, and there was no significant difference (RR = -0.20, 95% CI [-1.93,1.53], P > .05). The incidence of adverse events in the hydromorphone group was less than that in the sufentanil group, and there was a statistical difference: (RR = 0.61, 95% CI [0.47,0.79], P < .05).

Conclusion: Compared with sufentanil, PCA with hydromorphone was more effective in relieving pain and PCA requests 12, 24, and 48 hours after operation, and significantly reduced the incidence of adverse events, but it did not have an advantage in sedation 

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