论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
Authors Meng Y, Jiang H, Zhang C, Zhao J, Wang C, Gao R, Zhou X
Received 23 November 2016
Accepted for publication 6 January 2017
Published 14 February 2017 Volume 2017:10 Pages 405—415
DOI https://doi.org/10.2147/JPR.S128523
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Michael E Schatman
Abstract: Postoperative analgesia remains a challenge for orthopedic surgeons. The
aim of this meta-analysis is to compare the efficacy of epidural analgesia (EA)
and intravenous patient-controlled analgesia (IV-PCA) following major spine
surgery. We searched electronic databases, including the PubMed, EMBASE, Ovid
and Cochrane databases, for randomized controlled trials (RCTs) published
before June 2016. The quality of the included trials was assessed using the
Cochrane risk-of-bias tool. Random effects models were used to estimate the
standardized mean differences (SMDs) and relative risks (RRs), with the
corresponding 95% confidence intervals (CI). Subgroup analyses stratified by
the type of epidural-infused medication and epidural delivery were also
performed. A total of 17 trials matched the inclusion criteria and were chosen
for the following meta-analysis. Overall, EA provided significantly superior
analgesia, higher patient satisfaction and decreased overall opioid consumption
compared with IV-PCA following major spine surgery. Additionally, no
differences were found in the side effects associated with these two methods of
analgesia. Egger’s and Begg’s tests showed no significant publication bias. We
suggest that EA is superior to IV-PCA for pain management after major spine
surgery. More large-scale, high-quality trials are needed to verify these
findings.
Keywords: adolescent
idiopathic scoliosis, lumbar fusion, epidural analgesia, intravenous
application, perioperative pain