纳布啡用于术后镇痛有效性与安全性的Meta分析

目的:系统评价纳布啡用于术后镇痛的有效性和安全性,为临床合理用药提供循证参考。方法:计算机检索Embase、Medline、PubMed、中国学术期刊全文数据库、维普数据库和万方数据库,收集纳布啡(试验组)对比其他镇痛药(对照组)用于术后镇痛的随机对照试验(RCT)。经筛选文献、提取资料并按照改良的Jadad评分量表评价文献质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入10项RCT,共计796例患者。Meta分析结果显示,两组患者镇痛满意率OR=1.11,95%CI(0.70,1.74),P=0.66]、恶心发生率OR=1.20,95%CI(0.79,1.83),P=0.39]、呕吐发生率OR=1.02,95%CI(0.69,1.50),P=0.92]、嗜睡发生率OR=1.32,95%CI(0.47,3.76),P=0.06]比较,差异均无统计学意义;试验组患者皮肤瘙痒发生率OR=0.29,95%CI(0.14,0.58),P=0.000 6]、呼吸抑制发生率OR=0.21,95%CI(0.08,0.58),P=0.003]、尿潴留发生率OR=0.05,95%CI(0.01,0.37),P=0.004]均显著低于对照组。结论:纳布啡用于术后镇痛的有效性和安全性均较好。

Efficacy and Safety of Nalbuphine for Post-operative Analgesia:a Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of nalbuphine for postoperative analgesia systematically,and to provide evidence-based reference in clinic.METHODS:Retrieved from Embase,Medline,PubMed,CNKI,VIP and Wanfang database,RCTs about nalbuphine hydrochloride(trial group)vs.other analgesics(control group)for postoperative analgesia were collected.After literature screening,data extraction and literature quality evaluation with modified Jadad scale,Meta-analysis was performed by using Rev Man 5.3 statistical software.RESULTS:A total of 10 RCTs were included,involving 796 patients.Results of Meta-analysis showed that there was no statistical significance in satisfaction rate of analgesiaOR=1.11,95%CI(0.70,1.74),P=0.66],the incidence of nauseaOR=1.20,95%CI(0.79,1.83),P=0.39],vomitingOR=1.02,95%CI(0.69,1.50),P=0.92]or narcolepsyOR=1.32,95%CI(0.47,3.76),P=0.06]between 2 groups.The incidence of pruritusOR=0.29,95%CI(0.14,0.58),P=0.000 6],respiratory depressionOR=0.21,95%CI(0.08,0.58),P=0.003]and uroschesisOR=0.05,95%CI(0.01,0.37),P=0.004]in trial group were significantly lower than control group.CONCLUSIONS:Nalbuphine has better efficacy and safety for postoperative analgesia.