地塞米松联合地佐辛超前镇痛对外科术后镇痛效果的Meta-分析

目的 系统评价地塞米松联合地佐辛超前镇痛用于外科术后镇痛效果和安全性，为临床应用提供循证医学证据。方法 计算机检索PubMed、Embase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普数据库（VIP）和万方数据库，收集地塞米松联合地佐辛（试验组）和单用地佐辛（对照组）超前镇痛用于外科术后镇痛的随机对照研究，检索时限为从建库-2018年5月，提取有效数据后，应用RevMan 5.2软件进行Meta-分析。结果 共纳入13项研究，893例患者。Meta-分析结果显示：试验组术后的VAS评分在2 h （MD=-0.63，95%CI=-0.86~-0.41，P<0.01）、4 h （MD=-0.31，95%CI=-0.41~-0.21，P<0.01）、8 h （MD=-0.85，95%CI=-1.08~-0.62，P<0.01）、12 h （MD=-0.89，95%CI=-1.05~-0.72，P<0.01）、24 h （MD=-1.16，95%CI=-1.49~-0.82，P<0.01）均小于对照组；镇痛药追加率（RR=0.08，95%CI=0.02~0.32，P<0.01）小于对照组；患者镇静满意度（RR=1.18，95%CI=1.07~1.31，P<0.01）高于对照组；恶心、呕吐发生率（RR=0.41，95%CI=0.30~0.56，P<0.01）低于对照组。结论 地塞米松联合地佐辛具有良好的协同作用，可有效减轻术后疼痛，减少恶心呕吐发生，值得临床推广。

Meta-analysis of preoperative analgesia with dexamethasone combined with dizocine for postoperative analgesia

Objective To evaluate the postoperative analgesia effect and safety of dexamethasone combined with dizocine in surgical patient,and provide evidence-based medical evidence for clinical applications.Methods The related databases of PubMed,Embase,CNKI,CBM,VIP,and Wanfang were electronically searched for clinical randomized controlled study about dexamethasone combined with dizocine (test group) vs dizocine alone (control group) in surgical patient from database establishment to May 2018,Meta-analysis using RevMan 5.2 software after extracting valid data.Result A total of 13 studies involving 893 patients were entered.Meta-analysis showed that,the test group in VAS score of 2 h after operation (MD=-0.63,95%CI=-0.86~-0.41,P<0.01),4 h after operation (MD=-0.31,95%CI=-0.41~-0.21,P<0.01),8 h after operation (MD=-0.85,95%CI=-1.08~-0.62,P<0.01),12 h after operation (MD=-0.89,95%CI=-1.05~-0.72,P<0.01) and 24 h after operation (MD=-1.16,95%CI=-1.49~-0.82,P<0.01) much lower than that in the control group;analgesic rate (RR=0.08,95%CI=0.02~0.32,P<0.01) of the test group much lower than that in the control group;patient sedation satisfaction (RR=1.18,95%CI=1.07~1.31,P<0.01) of the test group much higher than that in the control group;Incidence of nausea and vomiting (RR=0.41,95%CI=0.30~0.56,P<0.01) of the test group much lower than that in the control group.Conclusion Dexamethasone combined with dextrozine has a good synergistic and additive effect,which can effectively reduce postoperative pain and reduce the incidence of nausea and vomiting,which is worthy of clinical promotion.