Abstract：
BACKGROUND: Thyroidectomy is a common surgical procedure. Traditional options for pain management, such as analgesics and nonsteroidal anti-inflammatory medications (NSAIDs), are limited by their side effects. Surgical wound infiltration with local anesthetics has the potential to reduce the need for analgesics in a number of surgical procedures. This systematic review and meta-analysis wanted to resolve these concerns and assess the efficacy of WI in the management of postoperative pain after thyroidectomy.
METHODS: The review adhered to Cochrane Collaboration and PRISMA standards. RCTs comparing WI with no infiltration or placebo were included. Patients with benign or malignant thyroid disease who underwent open thyroidectomy were eligible. Postoperative pain was assessed using a visual analogue scale (VAS) as the primary outcome. Time to first rescue dose, the need for analgesic rescue in the first 24 h, and total opioid analgesic consumption were secondary outcomes. Standardized mean difference (SMD) and odds ratio (OR) were used to analyze the data.
RESULTS: 16 randomized controlled trials involving 1202 patients were included. At 6 and 8 h postoperatively, WI exhibited a statistically significant impact on pain management. In the WI group, the need for analgesic rescue was significantly reduced. At 4 h postoperatively, non-anesthetic medications demonstrated a significant analgesic effect.
CONCLUSIONS: This systematic review and meta-analysis support the use of WI with local anesthetics for postoperative pain management after thyroidectomy. These findings have significant implications for improving perioperative care, especially in ambulatory settings where effective pain management is essential.
METHODS: The review adhered to Cochrane Collaboration and PRISMA standards. RCTs comparing WI with no infiltration or placebo were included. Patients with benign or malignant thyroid disease who underwent open thyroidectomy were eligible. Postoperative pain was assessed using a visual analogue scale (VAS) as the primary outcome. Time to first rescue dose, the need for analgesic rescue in the first 24 h, and total opioid analgesic consumption were secondary outcomes. Standardized mean difference (SMD) and odds ratio (OR) were used to analyze the data.
RESULTS: 16 randomized controlled trials involving 1202 patients were included. At 6 and 8 h postoperatively, WI exhibited a statistically significant impact on pain management. In the WI group, the need for analgesic rescue was significantly reduced. At 4 h postoperatively, non-anesthetic medications demonstrated a significant analgesic effect.
CONCLUSIONS: This systematic review and meta-analysis support the use of WI with local anesthetics for postoperative pain management after thyroidectomy. These findings have significant implications for improving perioperative care, especially in ambulatory settings where effective pain management is essential.
摘要：
背景：甲状腺切除术是一种常见的外科手术。传统的疼痛管理选择，如镇痛药和非甾体抗炎药（NSAIDs），受到副作用的限制。局部麻醉剂的手术伤口浸润有可能减少许多外科手术中对镇痛药的需求。这项系统评价和荟萃分析希望解决这些问题，并评估WI在甲状腺切除术后疼痛管理中的功效。
方法：审查遵循CochraneCollaboration和PRISMA标准。包括比较没有浸润或安慰剂的WI的RCT。接受开放性甲状腺切除术的良性或恶性甲状腺疾病患者符合条件。使用视觉模拟评分（VAS）评估术后疼痛作为主要结果。第一次抢救剂量的时间到了，在最初的24小时内需要镇痛抢救，阿片类镇痛药的总消耗量是次要结局.采用标准化均差(SMD)和比值比(OR)对数据进行分析。
结果：纳入了涉及1202例患者的16项随机对照试验。术后6和8小时，WI对疼痛管理表现出统计学上显著的影响。在WI集团，镇痛抢救的必要性显著降低.术后4小时，非麻醉药物显示出显着的镇痛作用。
结论：本系统综述和荟萃分析支持WI联合局部麻醉药用于甲状腺切除术后疼痛管理。这些发现对改善围手术期护理具有重要意义。特别是在门诊环境中，有效的疼痛管理是必不可少的。
方法：审查遵循CochraneCollaboration和PRISMA标准。包括比较没有浸润或安慰剂的WI的RCT。接受开放性甲状腺切除术的良性或恶性甲状腺疾病患者符合条件。使用视觉模拟评分（VAS）评估术后疼痛作为主要结果。第一次抢救剂量的时间到了，在最初的24小时内需要镇痛抢救，阿片类镇痛药的总消耗量是次要结局.采用标准化均差(SMD)和比值比(OR)对数据进行分析。
结果：纳入了涉及1202例患者的16项随机对照试验。术后6和8小时，WI对疼痛管理表现出统计学上显著的影响。在WI集团，镇痛抢救的必要性显著降低.术后4小时，非麻醉药物显示出显着的镇痛作用。
结论：本系统综述和荟萃分析支持WI联合局部麻醉药用于甲状腺切除术后疼痛管理。这些发现对改善围手术期护理具有重要意义。特别是在门诊环境中，有效的疼痛管理是必不可少的。
