2017 年第 10 期 第 12 卷

氟比洛芬酯联合地佐辛在术后静脉自控镇痛中有效性和安全性的系统评价

Effectiveness and safety of flurbiprofen axetil combined with dezocine for postoperative patient-controlled intravenous analgesia: a systematic review

作者：陈鹏陈富超顾俊峰周本宏

英文作者：Chen Peng Chen Fuchao Gu Junfeng Zhou Benhong

单位：430060武汉大学人民医院药学部(陈鹏、周本宏)；442008湖北省十堰市，湖北医药学院附属东风医院药学部（陈富超）;442008湖北省十堰市，湖北医药学院附属人民医院疼痛科（顾俊峰）

英文单位：Department of Pharmacy Renmin Hospital of Wuhan University Wuhan 430060 China（Chen P Zhou BH）; Department of Pharmacy Dongfeng Hospital Affiliated to Hubei University of Medicine Hubei Province Shiyan 442008 China（Chen FC）; Department of Pain Renmin Hospital Affiliated to Hubei University of Medicine Hubei Province Shiyan 442008 China（Gu JF）

关键词：术后静脉自控镇痛；地佐辛；氟比洛芬酯；系统评价

英文关键词：Postoperativepatient-controlledintravenousanalgesia;Dezocine;Flurbiprofenaxetil;Systematicreview

• 摘要：

• 目的 系统评价氟比洛芬酯联合地佐辛在术后静脉自控镇痛（PCIA）中的有效性和安全性。方法 计算机检索 PubMed，Web of science，ISI，Cochrane database of systematic reviews，Embase，中国期刊全文数据库、万方数据库、维普中文科技期刊数据库和中国生物医学文献数据库，纳入氟比洛芬酯联合地佐辛用于术后PCIA的随机对照试验（RCT）。将患者分为氟比洛芬酯联合地佐辛组（联合用药组），单用氟比洛芬酯组（F组）和单用地佐辛（D组）。按照纳入与排除标准进行文献筛选及数据提取，记录患者术后PCIA中的疼痛视觉模拟量表（VAS）评分、Ramsay评分和术后不良反应。采用RevMan 5.3软件进行Meta分析。结果 共纳入14个RCT，共1 246例患者。Meta分析结果显示，联合用药组术后12、24、48 h VAS评分低于D组，术后12、24 h VAS评分低于F组，术后12、24 h Ramsay评分低于D组，8、12、24 h Ramsay评分低于F组（均P<0.05）。联合用药组恶心呕吐、嗜睡发生率和不良反应总发生率明显低于D组（比值比=0.23、0.29、0.22，95%置信区间：0.14~0.35、0.11~0.77、0.15~0.32，P<0.05）和F组（比值比=0.23、0.25、0.18，95%置信区间：0.12~0.47、0.09~0.69、0.10~0.31，P<0.05）。结论 与单用地佐辛或氟比洛芬酯相比，氟比洛芬酯联合地佐辛在术后PCIA中具有较好的镇痛镇静效果，明显降低不良反应发生率。

• Objective To evaluate effectiveness and safety of flurbiprofen axetil combined with dezocine for postoperative patient-controlled intravenous analgesia（PCIA）. Methods Randomized clinical trials about flurbiprofen axetil combined with dezocine for postoperative PCIA were searched in PubMed, Web of Science, ISI, Cochrane Database of Systematic Reviews, Embase, Chinese Journal Full-text Database, Wanfang Database, VIP Database and China Biology Medicine Database. Patients were divided into flurbiprofen plus dezocine group, flurbiprofen group and dezocine group. Clinical data including Visual Analogue Scale（VAS） score, Ramsay score and postoperative adverse reactions were abstracted. Meta analysis was conducted using RevMan 5.3 software. Results Totally 1 246 patients in 14 trails were included in present analysis. In flurbiprofen plus dezocine group, postoperative 12, 23, 48 h VAS scores were significantly lower than those in dezocine group; postoperative 12, 24 h VAS score were significantly lower than those in flurbiprofen group; postoperative 12, 24 h Ramsay score were significantly lower than those in dezocine group; postoperative 8, 12, 24 h Ramsay score were significantly lower than those in flurbiprofen group（P＜0.05）. Incidences of nausea, vomiting, drowsiness and the total incidence of adverse reactions in flurbiprofen plus dezocine group were significantly lower than those in dezocine group（odds radio=0.23, 0.29, 0.22， 95% confidence interval: 0.14-0.35, 0.11-0.77, 0.15-0.32， P<0.05） and flurbiprofen group（odds radio=0.23, 0.25, 0.18， 95% confidence interval: 0.12-0.47, 0.09-0.69, 0.10-0.31， P<0.05）. Conclusion Postoperative PCIA with flurbiprofen plus dezocine has better analgesia and sedation effects and less adverse effects compared with using flurbiprofen or dezocine alone.