摘要
目的系统评价曲马多用于术后临床镇痛的效果及安全性。方法采用电子检索PubMed、EBSCO、Springer、Ovid、CNKI等数据库，收集1999年-2010年发表的关于曲马多术后镇痛的随机对照试验（RCT），按Cochrane系统评价的方法评价纳入研究的质量和提取资料，并采用RevMan软件进行统计分析。结果纳入研究19篇（982例患者）文献进行RCT。Meta分析结果显示：（1）有效性：术中静注曲马多镇痛，术后1、4、6、8、12和48h VAS评分曲马多组均明显低于生理盐水组[WMD（95％CI）分别为-1．13（-1．99，-0．27），-1．91（-2．88，-0．95），-1．52（-2．61，-0．42），-1.94（-2．70，-1．19），～1．51（-2．87，-0．15），-0．83（～1．31，-0．34）]（P〈0．05），术后12h曲马多组Ramsay评分大于生理盐水组[WMD（95％CI）0．59（-0．76，1.95）]，差异无统计学意义。（2）安全性：术后清醒时间、拔管时间曲马多组较生理盐水组延长[WMD（95％CI）分别2．12（0．08，4．15），3．21（0．81，5．60）]（P〈0．05），恶心呕吐发生率差异无统计学意义。结论术中给予曲马多能明显降低患者的术后疼痛，且不增加术后恶心呕吐发生率。
Objective To evaluate the efficacy and safety of intravenous tramadol for postoperative pain systematically. Methods We searched PubMed, EBSCO, Springer, Ovid and CNKI databases from 1999 to 2010 to identify randomized controlled trials （RCTs） about tramadol for postoperative pain. The quality of included RCTs and data adoption were assessed by Cochrane system. All the data were analyzed by RevMan software. Results Nineteen RCTs involving 982 patients were included in our study. The results of meta-analyses showed that： （1）Efficacy： VAS score was significantly lower within 1,4,6,8,12,48 hours postoperatively in the tramadol group than in the control[WMD（95%CI） - 1.13（-1.99,-0. 27）,-1.91（-2.88, -0.95）, -1.52（-2. 61, -0. 42）,-1.94（-2.70,-1.19）,-1.51（-2.87,-0. 15）,-0. 83（-1.31,-0.34）]（P〈0. 05）. Ramsay score in 12 hrs was significantly higher EWMD（95% CI） 0.59 （-0. 76,1.95）1. （2） Safety.. Recovery time and extubation time after surgery was longer than the control group [WMD（95% CI） were 2.12 （0.08,4. 15）, 3.21 （0.81,5.60）]（P〈0. 05）. There was no significant difference in the incidence of nausea and vomiting. Concision Intravenous tramadol during the operation can significantly decrease postoperative pain without any increment of adverse effects.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第10期965-967,共3页
Journal of Clinical Anesthesiology
