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目的评价对乙酰氨基酚对小儿术后镇痛的有效性,为临床提供一定的参考。方法采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆、MEDLINE、Pubmed等外文数据库,以及CNKI数据库、万方数据库、维普数据库等,采用RevMan5.2软件进行Meta分析。结果纳入研究9项,共783例患者,Meta分析显示,对乙酰氨基酚与丁哌卡因镇痛效果在24 h内没有显著差异,且安全性较好。与曲马多相比[95%CI(-0.87,-0.16),P=0.005],疗效虽不及曲马多,但副作用较少;与布洛芬比较,镇痛效果没有明显差异[95%CI(-0.63,0.39),P=0.65];与羟考酮比较,镇痛效果没有明显差异[95%CI(-0.84,5.04),P=0.16]。结论与几种镇痛药相比,对乙酰氨基酚对小儿术后镇痛效果只比曲马多差,且安全性更好。
Objective To evaluate the effectiveness of paracetamol on postoperative analgesia in children and provide a reference for clinical practice. Methods Cochrane Library, MEDLINE, Pubmed and other foreign databases, as well as CNKI database, Wanfang database and VIP database were searched by means of evidence-based literature analysis and evaluation methods. The RevMan5.2 software was used for Meta-analysis. The results were included in the study of 9, a total of 783 patients, Meta analysis showed that acetaminophen and bupivacaine analgesic effect within 24 h was no significant difference, and the safety is better. Compared with tramadol [95% CI (-0.87, -0.16), P = 0.005], although less effective than tramadol, but fewer side effects; compared with ibuprofen, analgesic effect was no significant difference [95% CI (-0.63,0.39), P = 0.65]. Compared with oxycodone, there was no significant difference in analgesic effect [95% CI (-0.84, 5.04, P = 0.16]. Conclusion Compared with several analgesics, paracetamol in children with postoperative analgesia effect only worse than tramadol, and better security.