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目的系统评价盐酸曲马多与高乌甲素术后患者自控镇痛(PCA)的临床效果与安全性。方法计算机检索Pub Med、The Cochrane Library、CBM、CNKI和Wan Fang Data,收集盐酸曲马多与高乌甲素术后PCA的随机对照试验(RCT),对纳入的RCT进行资料提取和质量评估后,对能够进行定量合成的结果采用Rev Man 5.2软件进行meta分析。结果共纳入11个RCT,共689例患者,meta分析结果显示:1 VAS评分:曲马多与高乌甲素组术后2、4、8、12、24和48 h评分均无统计学差异。2安全性:高乌甲素组术后恶心呕吐、头晕嗜睡、尿潴留等不良反应(ADR)的发生率较盐酸曲马多组低。结论现有证据表明,盐酸曲马多与高乌甲素术后PCA均能获得满意的镇痛效果,但高乌甲素ADR发生率低。但鉴于纳入研究的局限性,对该研究结果的可靠性尚需展开更多高质量、大样本的RCT予以证实。
Objective To evaluate the clinical efficacy and safety of tramadol hydrochloride and lappaconitine postoperative patient-controlled analgesia (PCA). Methods Randomized controlled trials (RCTs) of PCA of tramadol hydrochloride and lappaconitine were collected from Pub Med, The Cochrane Library, CBM, CNKI and Wan Fang Data. The RCTs were extracted and quality assessed , RevMan 5.2 software was used for meta-analysis of the results that could be quantitatively synthesized. Results A total of 11 RCTs were enrolled in the study. A total of 689 patients were included in the meta-analysis. The results of meta-analysis showed that there was no significant difference in the scores of 1, 2, 4, 8, 12, 24 and 48 h after tramadol and lappaconitine . 2 Safety: Lappaconitine postoperative nausea and vomiting, dizziness and drowsiness, urinary retention and other adverse reactions (ADR) occurred lower than the tramadol hydrochloride group. Conclusion The available evidence shows that both tramadol hydrochloride and lappaconitine postoperative PCA can obtain satisfactory analgesic effect, but the incidence of lappaconitine ADR is low. However, due to the limitations of the included studies, the reliability of the findings needs to be further verified by RCTs of high quality and large size.