| ABSTRACT Objective:To evaluate the efficacy and safety of sufentanil combined with ketamine for patient controlled analgesia (PCA). Methods: The randomized controlled trials of sufentanil combined with ketamine for PCA were searched in PubMed, Web of science, ISI, Cochrane database of Systematic Reviews, Embase, CNKI, VIP Data, Wanfang Data, SinoMed. After data extraction and quality assessment of the included RCTs, the RevMan 5.3 software was applied for Meta analysis of visual analog scale（VAS）score, Ramsay score, number of bolus applications of PCA and safety.Results:19 RCTs involving 1 746 participants were included. The results of Meta analyses showed that: As for visual analog scale (VAS) score, compared with the sufentanil group, the combined group (sufentanil combined with ketamine) had significant differences at 12 hour, 24 hour and 48 hour post operation (P<0.01); For ramsay sedation score, compared with the sufentanil group, the ramsay score at 24 hour post operation (WMD=-0.09, 95%CI: -0.16 to -0.02) and 48 hour post operation (WMD=-0.09, 95%CI: -0.12 to -0.06) had significant differences when sufentanil combined with ketamine (P<0.05）; There were significant differences in number of bolus applications of PCA at 24 hour post operation (WMD=-3.48, 95%CI: -4.64 to -2.31) and 48 hour post operation (WMD=-5.05, 95%CI: -6.56 to -3.54) between the combined group and the single sufentanil group (P<0.01); As for adverse reaction in the combined group compared with the single sufentanil group, nausea and vomiting, itchy skin, respiratory depression, mental disorder and incidences of adverse reaction were significantly decreased. Conclusion:According to the domestic evidence, sufentanil combined with ketamine for PCA could effectively alleviate post operative pain compared with sufentanil alone, and could be able to reduce the incindence of adverse reactions. |
