J Endod:术后给药对减轻非手术牙髓治疗术后疼痛的效果和安全性:一项系统性回顾和网络meta分析

2020-08-05 lishiting MedSci原创

这篇研究的目的是通过网络meta分析评估术后给药对非手术牙髓治疗术后疼痛的效果和安全性。

这篇研究的目的是通过网络meta分析评估术后给药对非手术牙髓治疗术后疼痛的效果和安全性。

研究搜寻了MEDLINE, EMBASE, CENTRAL, CINAHL和SCOPUS (until 31/07/2019)数据库。由2名评估者选取合格的随机对照试验,提取并对数据进行meta分析,施以不同干预管理并在术后6-8, 12, 24和48小时在0-100范围内[mean difference (MD); 95% credible interval (CrI) and surface under the cumulative ranking curve (SUCRA)]评估疼痛的治疗效果。采取Cochrane偏倚风险工具应用于合格的试验。由CINeMA web application获得GRADE方法,以此评估整个数据的质量。

结果显示,11项研究中共有8种干预方法:NSAIDs; NSAIDs+醋氨酚; NSAIDs+benzodiazepines; NSAIDs+阿片类药物; 皮质类固醇; 阿片类药物; 醋氨酚和安慰剂。与对照组相比,非手术牙髓治疗术后6-8小时疼痛在以下情况下得以缓解:1) NSAIDs+acetaminophen (MD=-22, 95%CrI=-38 to -7.2, SUCRA=73%, moderate confidence); 2) NSAIDs (MD=-21, 95%CrI=-34 to -7.6, SUCRA=68%, very low confidence)。在术后12和24小时,仅NSAIDs能够有效减轻疼痛。在48小时,没有任何疗法能够有效减缓疼痛。皮质类固醇和阿片类药物不能显著减少疼痛。未见更多关注安全性的报道。

结论:较低至中等水平质量的证据显示,非手术牙髓治疗后给予NSAIDs或NSAIDs+醋氨酚的药物管理会促使罹患不可逆牙髓炎或牙髓坏死的患者临床相关的术后疼痛减轻。术后给予皮质类固醇和阿片类药物不会显著减轻术后疼痛。

原始出处

Maryam Zanjir, Adam Sgro, et al. Efficacy and safety of post-operative medications in reducing pain following non-surgical endodontic treatment: a systematic review and network meta-analysis. J Endod., 2020 Jul 12;S0099-2399(20)30489-1. doi: 10.1016/j.joen.2020.07.002.

 

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    2021-05-15 jxrzshh
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    2021-03-05 一闲
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    2021-06-30 guojianrong
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1669875, encodeId=ff5716698e5a8, content=<a href='/topic/show?id=c7ca6e660ab' target=_blank style='color:#2F92EE;'>#牙髓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67660, encryptionId=c7ca6e660ab, topicName=牙髓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5eeb26562774, createdName=jxrzshh, createdTime=Sat May 15 13:56:23 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896721, encodeId=51fa1896e2127, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Mar 05 04:56:23 CST 2021, time=2021-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2017240, encodeId=b308201e24087, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Tue Apr 06 12:56:23 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888193, encodeId=193518881931b, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Jun 30 10:56:23 CST 2021, time=2021-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468092, encodeId=d3fd1468092f8, content=<a href='/topic/show?id=957b6e6754e' target=_blank style='color:#2F92EE;'>#牙髓治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67675, encryptionId=957b6e6754e, topicName=牙髓治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=876d6876924, createdName=hunizi007, createdTime=Fri Aug 07 12:56:23 CST 2020, time=2020-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047138, encodeId=5ff5104e13828, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Aug 06 00:56:23 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-06 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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