曲马多作为辅助效果为臂神经丛块局部麻醉剂:系统回顾和荟萃分析。

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Shin HW, Ju BJ,张成泽YK HS,康H,公园司法院

曲马多作为辅助效果为臂神经丛块局部麻醉剂:系统回顾和荟萃分析。

《公共科学图书馆•综合》。2017年9月27日,12 (9):e0184649。doi: 10.1371 / journal.pone.0184649。eCollection 2017。

PubMed ID

28953949 (在PubMed

]

文摘

背景:曲马多,4-phenyl-piperidine可待因的模拟,具有独特的作用,它有一个中央opioidergic去,含血清素的镇痛,周边局部麻醉(LA)的效果。许多研究报道相互矛盾的结果有关的外围镇痛效果曲马多作为辅助拉在臂神经丛块(BPB)。这一荟萃分析旨在评估曲马多作为一个兼职的影响在摄影领域的肩膀或上肢手术。方法:我们搜索PubMe必威国际appd和EMBASE,科克伦,KoreaMed数据库和谷歌学术搜索符合条件的随机对照试验(相关的),而单独拉BPB, BPB LA和曲马多。主要结果曲马多作为辅助的效果持续时间感觉块,运动块,和镇痛。次要结果曲马多作为辅助时间的影响开始感觉块和运动块和不利影响。我们使用审查经理5.3软件进行了荟萃分析。结果:我们确定了16个相关的751名患者。BPB与曲马多延长的时间感觉块(平均差(MD), -61.5分钟;95%可信区间,-95.5 - -27.6; P = 0.0004), motor block (MD, -65.6 min; 95% CI, -101.5 to -29.7; P = 0.0003), and analgesia (MD, -125.5 min; 95% CI, -175.8 to -75.3; P < 0.0001) compared with BPB without tramadol. Tramadol also shortened the time to onset of sensory block (MD, 2.1 min; 95% CI, 1.1 to 3.1; P < 0.0001) and motor block (MD, 1.2 min; 95% CI, 0.2 to 2.1; P = 0.010). In subgroup analysis, the duration of sensory block, motor block, and analgesia was prolonged for BPB with tramadol 100 mg (P < 0.05) but not for BPB with tramadol 50 mg. The quality of evidence was high for duration of analgesia according to the GRADE system. Adverse effects were comparable between the studies. CONCLUSIONS: In upper extremity surgery performed under BPB, use of tramadol 100 mg as an adjuvant to LA appears to prolong the duration of sensory block, motor block, and analgesia, and shorten the time to onset of sensory and motor blocks without altering adverse effects.

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曲马多