Article type
Abstract
"Background
Postoperative pain represents a prevalent clinical challenge following surgical procedures, affecting approximately 86% of patients, with 75% experiencing moderate to severe pain. There are many kinds of drugs for post- operative pain relief. However, current research primarily focuses on comparing the efficacy of two specific drugs.
Objectives
The aim of this study was to explore the efficacy and safety of different analgesic regimens for gynaecological postoperative pain through a systematic review and network meta-analysis.
Methods
We searched the PubMed, Cochrane Library, CINAHL, EMBASE, and MEDLINE with Full Text from their respective inception dates to September 17, 2023. Our inclusion criteria required patients to be over 20 years old and to have undergone gynecological abdominal surgery, including both laparotomy and laparoscopic procedures. The intervention method was analgesic drugs. The analgesic regimens included intravenous Morphine, intravenous Parecoxib, Intra Venous Patient Controlled Analgesia (IVPCA), multi-modal IVPCA and intramuscular Naldebain. Measured variables included postoperative pain intensity and adverse effects following drug administration. We appraisal by the Cochrane Risk of Bias tool for reviewing the study quality. A network meta-analysis was then performed to examine and compare its reducing pain intensity and adverse effects.
Results
A total of 16 articles were included in this study. The primary outcome were pain scores at 12 hours and 24 hours postoperatively. Secondary outcomes included comparisons of time to recovery and adverse effects such as nausea, vomiting, and dizziness. The study findings revealed that for the 12-hour analgesic effect, the most effective regimen was multi-modal IVPCA (-2.18 ,95% CI -4.01; -0.35) .Regarding the 24-hour analgesic effect, the best analgesic efficacy was Nalbuphine, although no clinically significant differences were observed (-1.21 ,95% CI -2.42; -0.01).In terms of adverse drug effects, IVPCA showed the highest relative risk ratio for nausea, vomiting, and dizziness. Morphine had the lowest incidence of nausea and vomiting, while Dynastat had the lowest incidence of dizziness.
Conclusions
The study's results aid patients in selecting suitable pain relief methods through shared decision-making. However, the numerous comparisons made lack direct clinical trial evidence, warranting further research for validation in the future."
Postoperative pain represents a prevalent clinical challenge following surgical procedures, affecting approximately 86% of patients, with 75% experiencing moderate to severe pain. There are many kinds of drugs for post- operative pain relief. However, current research primarily focuses on comparing the efficacy of two specific drugs.
Objectives
The aim of this study was to explore the efficacy and safety of different analgesic regimens for gynaecological postoperative pain through a systematic review and network meta-analysis.
Methods
We searched the PubMed, Cochrane Library, CINAHL, EMBASE, and MEDLINE with Full Text from their respective inception dates to September 17, 2023. Our inclusion criteria required patients to be over 20 years old and to have undergone gynecological abdominal surgery, including both laparotomy and laparoscopic procedures. The intervention method was analgesic drugs. The analgesic regimens included intravenous Morphine, intravenous Parecoxib, Intra Venous Patient Controlled Analgesia (IVPCA), multi-modal IVPCA and intramuscular Naldebain. Measured variables included postoperative pain intensity and adverse effects following drug administration. We appraisal by the Cochrane Risk of Bias tool for reviewing the study quality. A network meta-analysis was then performed to examine and compare its reducing pain intensity and adverse effects.
Results
A total of 16 articles were included in this study. The primary outcome were pain scores at 12 hours and 24 hours postoperatively. Secondary outcomes included comparisons of time to recovery and adverse effects such as nausea, vomiting, and dizziness. The study findings revealed that for the 12-hour analgesic effect, the most effective regimen was multi-modal IVPCA (-2.18 ,95% CI -4.01; -0.35) .Regarding the 24-hour analgesic effect, the best analgesic efficacy was Nalbuphine, although no clinically significant differences were observed (-1.21 ,95% CI -2.42; -0.01).In terms of adverse drug effects, IVPCA showed the highest relative risk ratio for nausea, vomiting, and dizziness. Morphine had the lowest incidence of nausea and vomiting, while Dynastat had the lowest incidence of dizziness.
Conclusions
The study's results aid patients in selecting suitable pain relief methods through shared decision-making. However, the numerous comparisons made lack direct clinical trial evidence, warranting further research for validation in the future."