目的:评估双侧颈浅丛阻滞(BSCPB)治疗甲状腺切除术后疼痛的有效性。
方法:MEDLINE,Embase,谷歌学者,LILACS,和Cochrane中央控制试验登记册,被广泛搜索。搜索期从1968年延长至2022年12月。比较BSCPB与安慰剂的随机对照试验,未纳入良性或恶性甲状腺疾病甲状腺切除术患者的阻滞.结果是手术后最初24小时疼痛。镇痛抢救,在第一次抢救剂量之前,24小时阿片类药物的使用是次要结局.使用RoB2仪器评估偏倚风险。
结果:354项研究中有34项是合格的。有2,519名患者。BSCPB降低了术后疼痛强度[SMD:-1.17(95%CI:-1.54至-0.81)]和前24小时[-0.62(95%:0.91至0.33)]。第一次阿片类药物剂量相当延迟,抢救镇痛药,术后阿片类药物的使用也被发现。
结论:BSCPB的24小时镇痛效果可最大限度地减少抢救镇痛的需求,术后阿片类药物摄入量,和抢救镇痛开始时间。麻醉药的选择和不同的应用方法可能会影响其有效性。
OBJECTIVE: To assess the effectiveness of bilateral superficial cervical plexus block (BSCPB) in treating post-thyroidectomy pain.
METHODS: MEDLINE, Embase, Google Scholar, LILACS, and the Cochrane Central Register of Controlled Trials, were extensively searched. The search period extended from 1968 until December 2022. Randomized controlled trials comparing BSCPB to placebo, no block in patients with thyroidectomy for benign or malignant thyroid disease were included. Outcomes were pain in the first 24 h after surgery. Analgesic rescue, period before the first rescue dosage, and 24-h opioid usage were secondary outcomes. The RoB 2 instrument was used to evaluate the risk of bias.
RESULTS: 34 of 354 studies were eligible. There were 2,519 patients. BSCPB reduced the intensity of pain postoperatively [SMD: - 1.17 (95% CI: - 1.54 to - 0.81)] and in the first 24 h [- 0.62 (95%: 0.91 to 0.33)]. A considerable delay for the first opioid dose, rescue analgesics, and postoperative opioid usage was also found.
CONCLUSIONS: BSCPB\'s 24-h analgesic efficacy minimizes the requirement for rescue analgesia, postoperative opioid intake, and rescue analgesia start time. The choice of anesthetic and different application methods might affect its effectiveness.