Efficacy and safety of patient-controlled opioid analgesia for acute postoperative pain A quantitative systematic review

摘要: Background: The usefulness of intravenous patient-controlled analgesia (PCA) with opioids for postoperative is not well defined. Methods: We systematically searched (MEDLINE, EMBASE, Cochrane Library, bibliographies, any language, to January 2000) randomised trials comparing opioid-based PCA the same opioid given intramuscularly, intravenously, or subcutaneously. Weighted mean differences (WMD) continuous data, relative risks (RR) and numbers-needed-to-treat (NNT) dichotomous data were calculated 95% confidence intervals (CI) using fixed random effects models. Results: Data from 32 analysed: 22 (1139 patients) morphine, five (682) pethidine, three (184) piritramide, one (47) nalbuphine (20) tramadol. In morphine pethidine trial (352 patients), more patients preferred (89.7% vs 65.8%, RR 1.41 (95%CI 1.11 1.80), NNT 4.2). Combined on pain intensity relief, need rescue analgesics eight (691 in favour (RR 1.22 (1.00 1.50), 8). two (152), pulmonary complications frequently prevented (100% 93.3%, 1.07 (1.01 1.14), 15). There was equivalence cumulative consumption, scores, duration hospital stay, opioid-related adverse effects. Conclusion: These provide some evidence that setting, opioids, compared conventional treatment, improve decrease risk complications, prefer them.