PDF(Pubmed)
Abstract：
National guidelines for rational opioid prescribing for acute postoperative pain are needed to optimise postoperative pain control and function whilst minimising opioid-related harm.
This overview of systematic reviews aims to summarise and critically assess the quality of systematic reviews related to the 20 recommendations from two previously published consensus guideline papers (ten relevant at patient and prescriber levels and ten at a system / Public Health level). It also aims to identify gaps in research that require further efforts to fill these in order to augment the evidence behind creating national guidelines for rational opioid prescribing for acute postoperative pain.
A systematic database search using PubMed/MEDLINE and Cochrane was conducted in November 2022. Furthermore, reference lists were reviewed. All identified systematic reviews were assessed for eligibility. Data from each study was extracted using a pre-standardised data extraction form. The methodological quality of the included reviews was assessed by two independent reviewers using the AMSTAR 2 checklist. Descriptive synthesis of the results was performed.
A total of 12 papers were eligible for analysis. Only eight out of the total 20 prioritised recommendations had systematic reviews that provided evidence related to them. These systematic reviews were most commonly of critically low quality.
The consensus papers provide guidance and recommendations based on the consensus of expert opinion that is based on the best available evidence. However, there is a lack of evidence supporting many of these consensus statements. Efforts to further analyse interventions that aim to reduce the rates of opioid prescribing and their adverse effects should therefore continue.
This overview of systematic reviews aims to summarise and critically assess the quality of systematic reviews related to the 20 recommendations from two previously published consensus guideline papers (ten relevant at patient and prescriber levels and ten at a system / Public Health level). It also aims to identify gaps in research that require further efforts to fill these in order to augment the evidence behind creating national guidelines for rational opioid prescribing for acute postoperative pain.
A systematic database search using PubMed/MEDLINE and Cochrane was conducted in November 2022. Furthermore, reference lists were reviewed. All identified systematic reviews were assessed for eligibility. Data from each study was extracted using a pre-standardised data extraction form. The methodological quality of the included reviews was assessed by two independent reviewers using the AMSTAR 2 checklist. Descriptive synthesis of the results was performed.
A total of 12 papers were eligible for analysis. Only eight out of the total 20 prioritised recommendations had systematic reviews that provided evidence related to them. These systematic reviews were most commonly of critically low quality.
The consensus papers provide guidance and recommendations based on the consensus of expert opinion that is based on the best available evidence. However, there is a lack of evidence supporting many of these consensus statements. Efforts to further analyse interventions that aim to reduce the rates of opioid prescribing and their adverse effects should therefore continue.
摘要：
背景：需要针对急性术后疼痛的合理阿片类药物处方的国家指南，以优化术后疼痛控制和功能，同时最大程度地减少与阿片类药物相关的伤害。
目的：本系统综述旨在总结和严格评估与先前发表的两份共识指南文件中的20项建议相关的系统综述的质量（十项与患者和处方者水平相关，十项与系统/公共卫生水平相关）。它还旨在确定研究中需要进一步努力填补这些空白的空白，以增加为急性术后疼痛制定合理阿片类药物处方的国家指南背后的证据。
方法：于2022年11月使用PubMed/MEDLINE和Cochrane进行了系统的数据库搜索。此外，参考列表进行了审查。对所有确定的系统评价进行资格评估。使用预先标准化的数据提取表提取来自每个研究的数据。两名独立审稿人使用AMSTAR2核对表评估了纳入的审查的方法学质量。进行结果的描述性合成。
结果：共有12篇论文符合分析条件。在总共20项优先建议中，只有8项进行了系统审查，提供了与之相关的证据。这些系统评价最常见的是质量极低。
结论：共识文件基于专家意见的共识提供指导和建议，该共识基于现有的最佳证据。然而,缺乏支持许多共识声明的证据。因此，应继续努力进一步分析旨在降低阿片类药物处方率及其不良反应的干预措施。
目的：本系统综述旨在总结和严格评估与先前发表的两份共识指南文件中的20项建议相关的系统综述的质量（十项与患者和处方者水平相关，十项与系统/公共卫生水平相关）。它还旨在确定研究中需要进一步努力填补这些空白的空白，以增加为急性术后疼痛制定合理阿片类药物处方的国家指南背后的证据。
方法：于2022年11月使用PubMed/MEDLINE和Cochrane进行了系统的数据库搜索。此外，参考列表进行了审查。对所有确定的系统评价进行资格评估。使用预先标准化的数据提取表提取来自每个研究的数据。两名独立审稿人使用AMSTAR2核对表评估了纳入的审查的方法学质量。进行结果的描述性合成。
结果：共有12篇论文符合分析条件。在总共20项优先建议中，只有8项进行了系统审查，提供了与之相关的证据。这些系统评价最常见的是质量极低。
结论：共识文件基于专家意见的共识提供指导和建议，该共识基于现有的最佳证据。然而,缺乏支持许多共识声明的证据。因此，应继续努力进一步分析旨在降低阿片类药物处方率及其不良反应的干预措施。
