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A Systematic Review of Postoperative Pain Outcome Measurements Utilised in Regional Anesthesia Randomized Controlled Trials

机译:区域麻醉随机对照试验中使用的术后疼痛结果测量的系统审查

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摘要

Introduction. Regional anesthesia is a rapidly growing subspecialty. There are few published meta-analyses exploring pain outcome measures utilised in regional anesthesia randomized controlled trials (RCTs), which may be due to heterogeneity in outcomes assessed. This systematic review explores postoperative pain outcomes utilised in regional anesthesia RCTs. Methods. A literature search was performed using three databases (Medline, Embase, and CINAHL). Regional anesthesia RCTs with postoperative pain as a primary outcome were included if written in English and published in one of the top 20 impact factor journals between 2005 and 2017. Study quality was assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Results. From the 31 included articles, 15 different outcome measures in total were used to assess postoperative pain. The most commonly (16/31) used outcome measures were verbal numerical grading of pain out of 10, total opioid consumption, and visual analogue scale 10 cm (VAS). The need for analgesia was used as an outcome measure where studies did not use a pain rating score. Ten studies reported pain scores on activity and 27/31 studies utilised ≥2 pain outcomes. Time of measurement of pain score also varied with a total of 51 different time points used in total. Conclusion. Analysis of the articles demonstrated heterogeneity and inconsistency in choice of pain outcome and time of measurement within regional anesthesia studies. Identification of these pain outcomes utilised can help to create a definitive list of core outcomes, which may guide future researchers when designing such studies.
机译:介绍。区域麻醉是一种迅速增长的亚专业。较少的荟萃分析探索区域麻醉随机对照试验(RCT)中使用的止痛结果措施,这可能是由于评估结果的异质性。该系统评论探讨了区域麻醉RCT中使用的术后疼痛结果。方法。使用三个数据库(Medline,Embase和Cinahl)执行文献搜索。如果用英语编写,则包括术后疼痛的区域麻醉RCT,并且在2005年至2017年期间的前20名影响因素期刊之一中出版。使用Cochrane Collaboration的工具评估了学习质量,以评估偏见风险。结果。从31篇文章中,总共15种不同的结果措施用于评估术后疼痛。最常见的(16/31)使用的结果措施是10个,总阿片类药物消耗和10厘米(VAS)的疼痛的口头数值分级。对镇痛的需求被用作研究没有使用止吐评分的结果措施。十项研究报告了活动的疼痛评分和27/31研究使用≥2疼痛结果。测量疼痛评分的时间也变化,总共有51个不同的时间点。结论。物品的分析证明了在区域麻醉研究中选择疼痛结果和测量时间的异质性和不一致。使用这些痛苦结果的鉴定可以帮助创造一个明确的核心结果清单,这可能会在设计这些研究时引导未来的研究人员。

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