Analgesic management of uncomplicated acute sickle-cell pain crisis in pediatrics: a systematic review and meta-analysis.
Analgesic management of uncomplicated acute sickle-cell pain crisis in pediatrics: a systematic review and meta-analysis.
复制标题
对儿科中简单的急性镰状细胞疼痛危机的镇痛治疗：系统评价和荟萃分析。
DOI：
10.1016/j.jped.2019.05.004
复制
发表时间：
2020-03
影响因子：
3.3
通讯作者：
Zhao, Dongchi
中科院分区：
文献类型：
--
作者：
Saramba, Manou Irmina;Shakya, Sandeep;Zhao, Dongchi
获取与安慰剂相比，药物镇痛对儿科患者无并发症急性镰状细胞性疼痛的有效性和安全性的证据。2018年3月1日至31日检索了关键证据，对儿童样本中非复杂性急性镰状细胞性疼痛的药物镇痛与安慰剂的随机对照试验进行了检索。作者检索了10个科学数据库，包括PubMed、MEDLINE、Embase和Clinicaltrials.gov，以进行系统回顾和荟萃分析。根据纳入标准（芬太尼鼻内、镁静脉注射、精氨酸和吸入一氧化氮）选择4项试验（n = 227）。每个结果的证据质量从低到中等不等。对疼痛评分阶梯（p = 0.72）、住院时间（p = 0.65）、麻醉药物用量（p = 0.10）的变化进行meta分析，结果显示治疗组疼痛评分差异无统计学意义，且药物镇痛药没有改善作用。不良事件报告显示，干预组中更多的参与者出现疼痛，在使用芬太尼鼻内和静脉注射镁的研究中，药物传递部位的差异有统计学意义（p = 0.03）。药物镇痛似乎是不确定的，以提高强度和提供缓解急性疼痛危象的儿童镰状细胞性贫血患者。就临床优势而言，这些药物在小儿年龄段急性镰状细胞性疼痛治疗中的临床疗效尚未得到决定性的推断。
To capture evidence of the efficacy and safety of pharmacological analgesia for uncomplicated acute sickle-cell pain in pediatric patients compared to placebo. Searches for key evidence were performed from March 1 to 31, 2018, for randomized controlled trials of pharmacological analgesia compared to placebo for uncomplicated acute sickle-cell pain in a pediatric sample. The authors searched ten scientific databases including, among others, PubMed, MEDLINE, Embase, and Clinicaltrials.gov for this systematic review and meta-analysis. Four trials (n = 227) were selected by the inclusion criteria (intranasal fentanyl, intravenous magnesium, arginine, and inhaled nitric oxide). The quality of evidence ranged from low to moderate for each outcome. Meta-analysis of changes in the ladder of pain score (p = 0.72), length-of-stay in hospital (p = 0.65), and amount of narcotics used during the study (p = 0.10) showed non-statistically significant differences and a lack of amelioration provided by pharmaceutical analgesics in treatment group. The adverse events reported that more participants in the intervention arm underwent pain, with statistically significant differences at the drug delivery site in studies using intranasal fentanyl and intravenous magnesium (p = 0.03). Pharmacological analgesia appears to be uncertain in improving the intensity and providing relief of acute pain crisis in pediatric patients with sickle-cell anemia. With respect to clinical advantage, no decisive deduction about the clinical efficacy may be made regarding these medications in acute sickle-cell pain management in the pediatric age group.
登录
查看更多内容
影响因子：
2.6
作者：
Adegoke, Samuel Ademola;Shehu, Umar Abdullahi;Oyelami, Oyeku Akibu
通讯作者：
Oyelami, Oyeku Akibu
影响因子：
12.8
作者：
Archer N;Galacteros F;Brugnara C
通讯作者：
Brugnara C
影响因子：
20.3
作者：
Brousseau, David C.;Scott, J. Paul;Panepinto, Julie A.
通讯作者：
Panepinto, Julie A.
影响因子：
120.7
作者：
Brousseau, David C.;Owens, Pamela L.;Steiner, Claudia A.
通讯作者：
Steiner, Claudia A.
DOI：
10.1177/1740774513475850
发表时间：
2013-04
期刊：
Clinical trials (London, England)
影响因子：
--
作者：
Dampier CD;Smith WR;Wager CG;Kim HY;Bell MC;Miller ST;Weiner DL;Minniti CP;Krishnamurti L;Ataga KI;Eckman JR;Hsu LL;McClish D;McKinlay SM;Molokie R;Osunkwo I;Smith-Whitley K;Telen MJ;Sickle Cell Disease Clinical Research Network (SCDCRN)
通讯作者：
Sickle Cell Disease Clinical Research Network (SCDCRN)