超前镇痛对开胸术后疼痛综合征发生影响Meta分析.docVIP

超前镇痛对开胸术后疼痛综合征发生影响的Meta分析 　　作者：陶利军　　作者单位：内蒙古医学院附属医院麻醉科，内蒙古 呼和浩特 　　【摘要】目的：对超前镇痛能否预防开胸术后疼痛综合征的发生进行系统评价。方法：计算机检索MEDLINE(1990-2006.6)、EMBASE(1989-2006.6)及中国生物医学文献数据库(CBM) (1978-2006.6)，手工检索纳入试验的所有中文及外文文献及相关文献，收集所有对有关超前镇痛与开胸术后疼痛综合征的随机对照临床试验，对其逐个进行方法学质量评价，并用RevMan4.2.8进行Meta分析。结果：共纳入2个随机对照试验，99例应用超前镇痛行开胸手术的患者;均为高质量研究，Meta分析结果显示：超前镇痛组与对照组比较在随访时间内其效应间差异无统计学意义，开胸术后慢性痛合并优势比为0.51[95%CI(0.19，1.34),P=0.17]。 结论：目前无足够证据证明超前镇痛能够有效预防和降低开胸术后慢性痛的发生，尚需要更多设计严谨、方法科学的高质量随机对照试验。 　　【关键词】 超前镇痛;疼痛;胸部手术;Meta分析 　　A Meta-analysis of the Effect of Preemptive Analgesia on the Post-thoracotomy Pain Syndrome　　TAO Lijun　　(Department of Anaesthesia, the Affiliated Hospital of Inner Mongolia Medical College, Huhehot 010050,China) 　　Abstract Objective:To examine whether preemptive analgesia can prevent the post-thoractomy pain syndrome.Methods: Using the methods of The Cochrane Collaboration, a systematic review of the relevant randomized controll trials (RCTs) of pre-emptive analgesia for chronic post-thoracotomy pain was performed.The literature related to trials was collected form MEDLINE(1990-2006.6), EMBASE(1989-2006.6), CBM (1978-2006.6), and all articles in Chinese and English involved in trails were handsearched.The quality of literature was reviewed, and data were extracted by two reviewers independently.Meta-analysis was conducted using RevMan 4.2 software.Results: Two RCTs involving 99 patients were included and all were of high methodological quality according to Jadad scale(the Jadad score3).Meta-analysis indicated that no statistical difference was detected between preemptive analgesia group and the controll groups in effectiveness in the follow-up time, with OR 0.51 [95%CI(0.19，1.34)P=0.17].Conclusions: Comparing preemptive analgesia with the controlled, current evidence can not evaluate whether preemptive analgesia is significantly effective for chronic post-thoracotomy pain, more RCTs of high methodological quality and better techniques are required. 　　Key words Pre