无阿片类药物麻醉对术后恢复评分质量的影响：随机对照试验的荟萃分析

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-04-01 DOI:10.1016/j.jclinane.2025.111823

Di Wang M.D , Zhi Liu M.D. , Wenhui Zhang M.D. , Siru Li M.D. , Yutao Chen M.D. , Xingguo Li M.D. , Congjie Bi Ph.D.

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引用次数: 0

摘要

本荟萃分析旨在评估无阿片类药物麻醉（OFA）对术后主观恢复质量（QoR）的影响。方法综合检索PubMed、Embase、Cochrane Library和谷歌Scholar等文献，进行有针对性的临床试验，评估OFA与阿片类药物麻醉（OBA）对术后QoR的影响。使用Review Manager、STATA和分级推荐评估、发展和评估（GRADE）分析器分析数据。本荟萃分析纳入13项随机对照试验（RCTs）。OFA显著提高QoR-15评分(SMD 2.16；95% ci 0.13-4.20；i2 = 98%；3项试验293例患者)和QoR-40评分(SMD 0.47；95% ci 0.18-0.77；i2 = 82%；236项试验1464名患者)。此外，恶心、呕吐和低血压的发生率降低，心动过缓的风险和拔管时间没有差异。结论OFA改善了术后早期恢复质量，减少了恶心、呕吐和低血压的发生，且未增加心动过缓的风险或延长气管拔管时间。

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Opioid-free anesthesia for quality of recovery score after surgery: A meta-analysis of randomized controlled trials

Background

This meta-analysis aimed to evaluate the impact of opioid-free anesthesia (OFA) on the postoperative subjective quality of recovery (QoR).

Methods

Our comprehensive literature search, spanning PubMed, Embase, Cochrane Library, and Google Scholar, targeted clinical trials that evaluated the effects of OFA versus opioid-based anesthesia (OBA) on postoperative QoR. The data were analyzed using Review Manager, STATA, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) profiler.

Main results

This meta-analysis included 13 randomized controlled trials (RCTs). OFA significantly improved the QoR-15 score (SMD 2.16; 95 % CI 0.13–4.20; I² = 98 %; 293 patients in 3 trials) and QoR-40 score (SMD 0.47; 95 % CI 0.18–0.77; I² = 82 %; 1464 patients in 236 trials). Furthermore, the incidence of nausea, vomiting, and hypotension was reduced, with no difference in the risk of bradycardia or time for extubation of the trachea.

Conclusion

This meta-analysis shows OFA improves early postoperative quality of recovery and reduces the occurrence of nausea, vomiting, and hypotension without increasing the risk of bradycardia or prolonging the time for extubation of the trachea.

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.