目的:研究硬膜外地塞米松在术后疼痛管理中的作用。方法:在RevMan5.4中进行随机效应荟萃分析。结果:我们纳入了9项随机对照试验(RCT),共657例患者。地塞米松显示更长的镇痛持续时间(平均差异266.18分钟,95%CI[3.21,529.14];p0.05),术后第一天恶心和呕吐的发生率较低(风险比0.36,95%CI[0.18,0.71];p0.004),和较低的止吐需求(风险比0.33,95%CI[0.14,0.79];p0.01)。两组之间的疼痛减轻和住院时间没有差异。结论:地塞米松具有较长的镇痛作用,需要止吐药的患者数量减少,恶心和呕吐的发生率较低。
大手术后的疼痛可能很严重。有时患者需要在手术后服用额外的镇痛药。地塞米松是一种类固醇,这可能会减少这种疼痛和对止痛药的需求。我们想知道地塞米松是否减少了镇痛药的使用,手术后恶心和呕吐,疼痛,或住院时间。我们发现了9篇有657名患者的文章,比较了地塞米松和安慰剂。根据我们的分析,地塞米松不能减少疼痛或住院时间.然而,手术患者可以从减少恶心和呕吐以及需要药物治疗这些副作用中受益。由于参加人数少,我们的结论应该谨慎。
Aim: To study the effect of epidural dexamethasone in postoperative pain management. Methods: Random-effects meta-analysis was conducted in RevMan 5.4. Results: We included nine randomized-controlled trials (RCT) with 657 patients. Dexamethasone demonstrated longer analgesia duration (mean difference 266.18 minutes, 95% CI [3.21,529.14]; p 0.05), lower incidence of nausea and vomiting during the first postoperative day (risk ratio 0.36, 95% CI [0.18,0.71]; p 0.004), and lower antiemetic requirements (risk ratio 0.33, 95% CI [0.14,0.79]; p 0.01). No difference in pain reduction and the length of hospital stay was observed between the groups. Conclusion: Dexamethasone was associated with a longer analgesic effect, a lower number of patients requiring antiemetics, and lower incidences of nausea and vomiting.
Pain after major surgeries can be severe. Sometimes patients need to take additional analgesics after surgery. Dexamethasone is a steroid, which can potentially reduce this pain and the need for pain-relieving medications. We wanted to know whether dexamethasone reduces the use of analgesics, nausea and vomiting after surgeries, pain, or length of hospital stay. We found nine articles with 657 patients, which compared dexamethasone with a placebo. According to our analysis, dexamethasone does not decrease pain or length of hospital stay. However, surgery patients can benefit from a decrease in nausea and vomiting and the need for medications for these side effects. Due to the small number of participants, our conclusions should be taken with caution.