摘要
目的快速评价布托啡诺注射液用于术后镇痛的安全性、有效性和经济性,为医院新药遴选和临床治疗决策者提供循证证据。方法系统检索PubMed、Embase、Epistemonikos、中国知网和万方等数据库,纳入术后应用布托啡诺注射液镇痛的系统评价/meta分析、药物经济研究和卫生技术评估报告并提取数据,采用AMSTAR评价清单和CHEERS清单评估文献质量,最终呈现真实数据并进行客观的综合分析。结果共检索出164篇文献,纳入meta分析9篇、药物经济学研究3篇,未检索到相关卫生技术评估报告。综合分析显示,布托啡诺的镇痛起效时间和镇痛有效时间,因对照药品不同而结论不同。与单用其他药物或联合应用其他药物相比,布托啡诺可降低恶心呕吐、头晕眩晕、皮肤瘙痒、嗜睡和总不良反应发生率,但对腹胀、尿潴留、呼吸抑制、烦躁、锥体外系、低血压、阿氏评分、产妇用药后不良反应发生率和阴道分娩率等无显著影响。结论布托啡诺有效性因对照药品不同而存在差异,通常联合用药效果优于单一用药。相比于强阿片类药品,布托啡诺用于术后镇痛的恶心呕吐、头晕眩晕和皮肤瘙痒等不良反应发生率低,相比于曲马多、吗啡、芬太尼,布托啡诺安全性较好。经济学方面,与单用舒芬替尼或地佐辛或托烷司琼相比,联合应用布托啡诺的医疗总费用降低。
Objective To quickly evaluate the safety and cost-effectiveness of butorphanol injection for postoperative analgesia to provide evidence for hospital new drug screening and clinical treatment decision.Methods We systematicdly searched PubMed,Embase,Epistemonikos,China National Knowledge Infrastructure and Wanfang,etc..The postoperative use of butorphanol injection for analgesia was included,covering systematic review or meta-analysis,pharmacoeconomic research and health technology assessment(HTA)report.And according to the inclusion and exclusion criteria,the searched studies were checked for duplicate,preliminary screening,re-screening,reading through the full text and data collection.The AMSTAR evaluation checklist and the CHEERS checklist were used to assess the quality of the literatures,and finally real data presented and an objective comprehensive analysis conducted.Results Totally 164 articles were retrieved via rapid health technology assessment,including 9 meta-analyses and 3 pharmacoeconomics studies.No health technology assessment reports were retrieved.Comprehensive analysis showed that compared with drugs used alone or in combination with other drugs,the analgesic onset time and analgesic effective time of butorphanol varied with the control drugs.Butorphanol reduced the incidence of nausea and vomiting,dizziness,dizziness,skin itching,drowsiness and overall adverse reactions.However,it showed no obvious effect on abdominal distension,urinary retention,respiratory depression,irritability,extrapyramidal system,hypotension,apger score,the incidence of adverse reactions after maternal medication and the rate of vaginal delivery.Conclusion The effectiveness of butorphanol varies with control drugs.Generally,the combination efffect is better than single medication.Compared with opioids,butorphanol has a lower incidence of adverse reactions in nausea,vomiting,dizziness,and skin pruritus for postoperative analgesia,and is safer than tramadol,morphine,and fentanyl.In terms of cost-effectiveness,compared with
作者
王安妮
王然
冯欣
WANG An-ni;WANG Ran;FENG Xin(Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026)
出处
《中南药学》
CAS
2021年第11期2420-2425,共6页
Central South Pharmacy
基金
北京市医院管理中心临床医学发展专项经费资助(No.ZYLX202119)。
关键词
布托啡诺
快速卫生技术评估
镇痛
患者静脉自控镇痛
butorphanol
rapid health technology assessment
pain control
patient-controlled intravenous analgesia
