PDF(Pubmed)
Abstract：
BACKGROUND: Emergence delirium remains a major postoperative concern for children undergoing surgery. Nalbuphine is a synthetic mixed agonist-antagonist opioid, which is believed to reduce the incidence of emergence delirium in children. The primary objective was to examine the effect of nalbuphine on emergence delirium in children undergoing surgery.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were searched from their starting dates until April 2023. Randomized Clinical Trials (RCT) and observational studies comparing nalbuphine and control in children undergoing surgery were included.
RESULTS: Eight studies (n = 1466 patients) were eligible for inclusion of data analysis. Compared to the control, our pooled data showed that the nalbuphine group was associated with lower incidence of emergence delirium (RR = 0.38, 95% CI [0.30, 0.47], p < 0.001) and reduced postoperative pain scores (MD = -0.98, 95% CI [-1.92, -0.04], p = 0.04).
CONCLUSIONS: This review showed the administration of nalbuphine is associated with significant decrease in the incidence of emergence delirium and postoperative pain scores among children undergoing surgery. However, due to limited sample size, high degree of heterogeneity and low level of evidence, future adequately powered trials are warranted to explore the efficacy of nalbuphine on emergence delirium among the pediatric population.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were searched from their starting dates until April 2023. Randomized Clinical Trials (RCT) and observational studies comparing nalbuphine and control in children undergoing surgery were included.
RESULTS: Eight studies (n = 1466 patients) were eligible for inclusion of data analysis. Compared to the control, our pooled data showed that the nalbuphine group was associated with lower incidence of emergence delirium (RR = 0.38, 95% CI [0.30, 0.47], p < 0.001) and reduced postoperative pain scores (MD = -0.98, 95% CI [-1.92, -0.04], p = 0.04).
CONCLUSIONS: This review showed the administration of nalbuphine is associated with significant decrease in the incidence of emergence delirium and postoperative pain scores among children undergoing surgery. However, due to limited sample size, high degree of heterogeneity and low level of evidence, future adequately powered trials are warranted to explore the efficacy of nalbuphine on emergence delirium among the pediatric population.
摘要：
背景：发生谵妄仍然是接受手术的儿童术后的主要问题。纳布啡是一种合成的混合激动剂-拮抗剂阿片类药物，这被认为可以减少儿童出现谵妄的发生率。主要目的是检查纳布啡对手术儿童出现谵妄的影响。
方法：MEDLINE数据库，EMBASE,和CENTRAL从开始日期到2023年4月进行搜索。包括随机临床试验（RCT）和观察性研究，比较纳布啡和对照组在接受手术的儿童中。
结果：8项研究（n=1,466名患者）符合纳入数据分析的条件。与对照相比，我们的汇总数据显示纳布啡组出现谵妄的发生率较低(RR=0.38,95%CI[0.30,0.47],p<0.001）并降低术后疼痛评分（MD=-0.98，95％CI[-1.92，-0.04]，p=0.04)。
结论：本综述显示，在接受手术的儿童中，服用纳布啡与出现谵妄的发生率和术后疼痛评分显著降低相关。然而,由于样本量有限，高度异质性和低水平的证据，有必要在未来进行足够有效的试验,以探讨纳布啡对儿科人群中出现谵妄的疗效.
方法：MEDLINE数据库，EMBASE,和CENTRAL从开始日期到2023年4月进行搜索。包括随机临床试验（RCT）和观察性研究，比较纳布啡和对照组在接受手术的儿童中。
结果：8项研究（n=1,466名患者）符合纳入数据分析的条件。与对照相比，我们的汇总数据显示纳布啡组出现谵妄的发生率较低(RR=0.38,95%CI[0.30,0.47],p<0.001）并降低术后疼痛评分（MD=-0.98，95％CI[-1.92，-0.04]，p=0.04)。
结论：本综述显示，在接受手术的儿童中，服用纳布啡与出现谵妄的发生率和术后疼痛评分显著降低相关。然而,由于样本量有限，高度异质性和低水平的证据，有必要在未来进行足够有效的试验,以探讨纳布啡对儿科人群中出现谵妄的疗效.
