单剂量口服乙酰氯芬酸用于成人术后疼痛。
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李志强，李志强，李志强
单剂量口服乙酰氯芬酸用于成人术后疼痛。
Cochrane Database Syst Rev. 2009 7月8日;(3):CD007588。cd007588.pub2 doi: 10.1002/14651858.。
- PubMed ID
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19588436 (PubMed视图］
- 摘要
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背景:乙酰氯芬酸是非甾体抗炎药(NSAID)双氯芬酸的前药，广泛用于治疗急性和慢性疼痛。目前还没有已知的对其在急性术后疼痛镇痛效果的系统综述。本综述旨在评估口服乙酰氯芬酸治疗急性术后疼痛的有效性和安全性，采用已确定疼痛患者的临床研究，并采用标准方法测量主要超过6小时的结果。这种类型的研究已经使用了几十年，以确定药物具有镇痛特性。目的:评估单剂量口服乙酰氯芬酸治疗急性术后疼痛的疗效，以及任何相关的不良事件。必威国际app搜索策略:我们搜索了Cochrane图书馆(2009年第1期)，MEDLINE via Ovid(1966 - 2009年3月);EMBASE via Ovid(1980年至2009年3月);牛津镇痛数据库(1950年至1994年);以及文章的参考书目。选择标准:口服乙酰氯芬酸缓解成人急性术后疼痛的随机、双盲、安慰剂对照临床试验。 DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. The area under the "pain relief versus time" curve was used to derive the proportion of participants with paracetamol plus codeine and placebo or paracetamol alone experiencing least 50% pain relief over 4 to 6 hours, using validated equations. The number needed to treat to benefit (NNT) was calculated using 95% confidence intervals (CI). The proportion of participants using rescue analgesia over a specified time period, and time to use of rescue analgesia, were sought as additional measures of efficacy. Information on adverse events and withdrawals was also collected. MAIN RESULTS: Searches identified only one study (217 participants total), which used oral aceclofenac 150 mg in patients with established postoperative pain. Aceclofenac 150 mg could not be distinguished from placebo, though ibuprofen 400 mg was distinguished from placebo. AUTHORS' CONCLUSIONS: In the absence of evidence of efficacy for oral aceclofenac in acute postoperative pain (at least at 150 mg single dose), its use in this indication is not justified. Because trials clearly demonstrating analgesic efficacy in the most basic of acute pain studies are lacking, use in other indications should be evaluated carefully. Given the large number of effective drugs available in this and similar classes of analgesics, there is no urgent research agenda required to demonstrate the effective dose of aceclofenac in acute postoperative pain.
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