Journal of Shanghai Jiao Tong University (Medical Science) >
Application of two kinds of analgesia after colorectal cancer surgery: a meta-analysis
Online published: 2021-09-23
Supported by
Shanghai Municipal Education Commission of Nursing Gaoyuan Discipline Construction Project—Multidisciplinary Innovation Fund Project(Hlgy1808dxk)
·To explore the safety and the analgesia effect of intravenous analgesia and epidural analgesia in the patients with colorectal cancer after surgery.
·The literature search was conducted in the Chinese databases, i.e. CNKI, WanFang, CBM, and VIP, and the abroad databases, i.e. PubMed, Web of Science, Embase, Cochrane Library and Joanna Briggs Institute (JBI) for randomized controlled trials (RCTs), controlled clinical trials (CCTs) and case-control studies (CCSs) about the effects of intravenous analgesia and epidural analgesia on the patients with colorectal cancer after surgery from January 2010 to November 2020, in the languages of Chinese and English. Three researchers independently conducted literature screening and quality evaluation in strict accordance with the standards, and extracted effective data such as study type, sample size, age, intraoperative anesthesia mode, postoperative analgesic drugs and outcome indicators, which were input into RevMan 5.4 software for meta-analysis.
·A total of 20 literatures, including 13 RCTs, 6 CCTs and 1 CCS, involving 1 615 patients. There were 813 cases in the epidural analgesia group and 802 cases in the intravenous analgesia group. Compared with intravenous analgesia, postoperative epidural analgesia had significant lower visual analogue scores (VAS) of pain at 6 h, 24 h, and 48 h, shorter hospital stay and time to first feeding after operation, and lower incidences of ileus and nausea and vomiting (all P<0.05).
·Compared with intravenous analgesia, postoperative epidural analgesia for the colorectal neoplasms patients is better in the analgesic effect 6 h, 24 h, and 48 h after surgery, effectively shortens the hospital stay and time to first feeding after operation, and reduces the incidences of ileus and nausea and vomiting.
Zhi-ling CHEN , Chen LUO , Kang-jia ZHAO , Ling SHEN , San-lian HU . Application of two kinds of analgesia after colorectal cancer surgery: a meta-analysis[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(10) : 1344 -1350 . DOI: 10.3969/j.issn.1674-8115.2021.10.012
1 | 曹毛毛, 陈万青. GLOBOCAN 2020全球癌症统计数据解读[J]. 中国医学前沿杂志(电子版), 2021, 13(3): 63-69. |
2 | Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chin Med J (Engl), 2021, 134(7): 783-791. |
3 | 董福生, 李广伟, 孟卉, 等. 右美托咪定多模式镇痛对老年结直肠癌根治术后的镇痛效果及其对认知功能的影响[J]. 川北医学院学报, 2021, 36(2): 180-183. |
4 | Sadurní M, Beltrán de Heredia S, Dürsteler C, et al. Epidural vs. intravenous fentanyl during colorectal surgery using a double-blind, double-dummy design[J]. Acta Anaesthesiol Scand, 2013, 57(9): 1103-1110. |
5 | Day AR, Smith RV, Scott MJ, et al. Randomized clinical trial investigating the stress response from two different methods of analgesia after laparoscopic colorectal surgery[J]. Br J Surg, 2015, 102(12): 1473-1479. |
6 | 王晓茹, 侯俊德, 王志刚, 等. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响[J]. 湖南中医药大学学报, 2018, 38(A1): 694. |
7 | Hausken J, Fretland ?A, Edwin B, et al. Intravenous patient-controlled analgesia versus thoracic epidural analgesia after open liver surgery: a prospective, randomized, controlled, noninferiority trial[J]. Ann Surg, 2019, 270(2): 193-199. |
8 | Radovanovi? D, Radovanovi? Z, ?kori?-Joki? S, et al. Thoracic epidural versus intravenous patient-controlled analgesia after open colorectal cancer surgery[J]. Acta Clin Croat, 2017, 56(2): 244-254. |
9 | 王芬, 胡臻, 周英杰. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响[J]. 临床麻醉学杂志, 2016, 32(1): 38-41. |
10 | 郑辉哲, 林振孟, 严明芳, 等. 全麻联合硬膜外麻醉在腹腔镜结直肠手术中的应用[J]. 中国现代医药杂志, 2017, 19(9): 1-4. |
11 | 伍星, 姚蓝, 朱传林. 腹腔镜结直肠癌根治术患者应用不同麻醉镇痛方式的术后转归效果差异[J]. 当代医学, 2018, 24(31): 8-10. |
12 | 常旭飞. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响对比分析[J]. 家庭医药·就医选药, 2020(5): 64-65. |
13 | Wongyingsinn M, Baldini G, Charlebois P, et al. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program[J]. Reg Anesth Pain Med, 2011, 36(3): 241-248. |
14 | 李荣华. 不同镇痛方法对结肠癌根治术患者疼痛控制及血栓发生风险的研究[J]. 结直肠肛门外科, 2017, 23(2): 233-236. |
15 | 郭志伟, 王菲菲. 不同麻醉镇痛方式在行腹腔镜术结直肠癌患者中的应用研究[J]. 基层医学论坛, 2020, 24(16): 2308-2309. |
16 | 刘洋, 陈华, 蒋才建, 等. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响对比分析[J]. 按摩与康复医学, 2020, 11(10): 42-44. |
17 | 叶东婷, 王建科. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者的影响[J]. 现代诊断与治疗, 2018, 29(6): 844-846. |
18 | 徐冲敏, 宁倩明, 叶湛青. 腹腔镜结直肠癌根治术患者应用不同麻醉镇痛方式的术后转归对比[J]. 华夏医学, 2016, 29(3): 78-81. |
19 | 王福杰. 不同麻醉镇痛方式对腹腔镜直肠癌根治术患者术后转归的影响[J]. 深圳中西医结合杂志, 2018, 28(4): 20-22. |
20 | 任大鹏, 张春燕. 不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者的影响[J]. 上海医药, 2019, 40(15): 31-32, 96. |
21 | 祁凤灵, 李梦莹. 腹腔镜结直肠癌根治术患者应用不同麻醉镇痛方式的术后转归比较研究[J]. 中国农村卫生, 2018(23): 54-55. |
22 | 刘科, 徐红霞. 加速康复外科理念下不同镇痛方式对直肠癌根治术早期康复的影响[J]. 名医, 2018(8): 23. |
23 | Zhang XM, Jiang H. Application of sevoflurane inhalation combined with epidural anesthesia in patients with colorectal cancer and its effect on postoperative perceptual function[J]. Oncol Lett, 2019, 17(5): 4443-4448. |
24 | 梁林, 姜为民. 硬膜外镇痛和静脉镇痛对脊柱融合术后镇痛效果比较的meta分析[J]. 中国脊柱脊髓杂志, 2014, 24(5): 433-439. |
25 | Levy BF, Scott MJ, Fawcett W, et al. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery[J]. Br J Surg, 2011, 98(8): 1068-1078. |
26 | 陈功勤, 王腾祺, 孙海滨. 加速康复外科中多模式镇痛在腹腔手术的应用进展[J]. 医学理论与实践, 2019, 32(12): 1823-1825. |
27 | Li J, Pourrahmat M, Vasilyeva E, et al. Response to comment on ? ?Efficacy and safety of patient-controlled analgesia compared with epidural analgesia after open hepatic resection: a systematic review and meta-analysis''[J]. Ann Surg, 2019, 270(6): e143. |
28 | Alfonsi P, Slim K, Chauvin M, et al. French guidelines for enhanced recovery after elective colorectal surgery[J]. J Visc Surg, 2014, 151(1): 65-79. |
29 | 蒋丽萍, 吴煌福, 何贵省. 老年结直肠癌腹腔镜手术患者术后肠梗阻发生率及影响因素[J]. 中国老年学杂志, 2018, 38(6): 1338-1341. |
30 | 刘辉, 李丕彬, 韩景田, 等. 硬膜外自控镇痛对老年髋关节置换术患者术后镇痛效果及IL-6、IL-10和TNF-α的影响[J]. 检验医学与临床, 2017, 14(24): 3626-3628. |
31 | 王建荔, 张行, 阮林, 等. 恶性肿瘤患者术后硬膜外自控镇痛对IL-2和IL-6的影响[J]. 现代肿瘤学, 2009, 17(7): 1340-1342. |
32 | Abd El-Wahab Abu Shanab EH, Ayaad MG, El-Dabe AA, et al. A com-parative study between combined spinal anesthesia with bilateral thoracic paravertebral block and general anesthesia in laparoscopic cholecystectomy[J]. Tanta Med J, 2018, 46(1): 77-82. |
33 | 石海霞, 刘婧, 温再和, 等. 硬膜外自控镇痛在胸科手术术后镇痛中的临床应用[J]. 中华老年多器官疾病杂志, 2018, 17(5): 355-358. |
34 | 黄耿雄. 使用自控镇痛泵进行胸科术后止痛的效果观察[J]. 现代医药卫生, 2005(14): 1831-1832. |
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