Abstract：
OBJECTIVE: The purpose of this scoping review was to evaluate literature involving opioid-sparing medications in critically ill patients with a focus on clinically meaningful outcomes.
METHODS: Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
METHODS: Intensive care unit.
METHODS: Adult patients in an intensive care unit setting.
METHODS: None.
METHODS: PubMed and Cochrane Library were searched from October 1, 2019 to June 1, 2023. Inclusion criteria consisted of randomized controlled trials evaluating adjunctive analgesic use in adult patients in an intensive care unit setting.
RESULTS: There were 343 citations and titles identified in the initial search, with 328 remaining after removal of duplicates, 294 excluded at title and abstract screening, 34 available for full text review, and six included in the scoping review. Most studies reported modest reductions in opioid use as a secondary endpoint. Improvement in clinical outcomes such as reduction in duration of mechanical ventilation or delirium were reported in two trials with dexmedetomidine.
CONCLUSIONS: In recently published trials of adjunctive agents in critically ill patients, opioid-sparing effects were small. Data to support improvements in clinical outcomes remains limited.
METHODS: Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
METHODS: Intensive care unit.
METHODS: Adult patients in an intensive care unit setting.
METHODS: None.
METHODS: PubMed and Cochrane Library were searched from October 1, 2019 to June 1, 2023. Inclusion criteria consisted of randomized controlled trials evaluating adjunctive analgesic use in adult patients in an intensive care unit setting.
RESULTS: There were 343 citations and titles identified in the initial search, with 328 remaining after removal of duplicates, 294 excluded at title and abstract screening, 34 available for full text review, and six included in the scoping review. Most studies reported modest reductions in opioid use as a secondary endpoint. Improvement in clinical outcomes such as reduction in duration of mechanical ventilation or delirium were reported in two trials with dexmedetomidine.
CONCLUSIONS: In recently published trials of adjunctive agents in critically ill patients, opioid-sparing effects were small. Data to support improvements in clinical outcomes remains limited.
摘要：
目的：本范围综述的目的是评估涉及重症患者阿片类药物保留药物治疗的文献，重点关注有临床意义的结局。
方法：范围审查使用系统审查的首选报告项目和范围审查的Meta分析扩展。
方法：重症监护病房。
方法：重症监护病房的成年患者。
方法：无。
方法：从2019年10月1日至2023年6月1日检索了PubMed和Cochrane图书馆。纳入标准包括随机对照试验，评估重症监护病房中成年患者的辅助镇痛药使用。
结果：在最初的搜索中有343条引文和标题，删除副本后剩余328个，294在标题和摘要筛选中排除，34可用于全文审查，范围审查中包括六个。大多数研究报告称阿片类药物的使用适度减少作为次要终点。在两项使用右美托咪定的试验中报道了临床结果的改善，例如机械通气持续时间的减少或谵妄。
结论：在最近发表的危重病患者的辅助药物试验中，阿片类药物的保护作用很小。支持临床结果改善的数据仍然有限。
方法：范围审查使用系统审查的首选报告项目和范围审查的Meta分析扩展。
方法：重症监护病房。
方法：重症监护病房的成年患者。
方法：无。
方法：从2019年10月1日至2023年6月1日检索了PubMed和Cochrane图书馆。纳入标准包括随机对照试验，评估重症监护病房中成年患者的辅助镇痛药使用。
结果：在最初的搜索中有343条引文和标题，删除副本后剩余328个，294在标题和摘要筛选中排除，34可用于全文审查，范围审查中包括六个。大多数研究报告称阿片类药物的使用适度减少作为次要终点。在两项使用右美托咪定的试验中报道了临床结果的改善，例如机械通气持续时间的减少或谵妄。
结论：在最近发表的危重病患者的辅助药物试验中，阿片类药物的保护作用很小。支持临床结果改善的数据仍然有限。
