Dezocine for Preventing Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Dezocine is considered to be an alternative medication for managing postoperative pain. The aim of this study was to assess the efficacy and safety of this drug in this regard.

Methods: Medline, EMBASE and the Cochrane Central Register of Control Trials (CENTRAL) were searched to identify all randomized controlled trials (RCTs) that compare dezocine with placebo or dezocine with morphine on postoperative pain. The data were extracted and pooled using Mantel-Haenszel random effects model. Heterogeneity was tested using the I2 statistic with values >50% and Chi2 test with P ≤ 0.05 indicating obvious heterogeneity between the studies.

Results: Seven trials evaluating 665 patients were included. The number of patients with at least 50% pain relief was increased (N = 234; RR 3.04, 95% CI 2.27 to 4.08) and physician (N = 465; RR 2.84, 95% CI 1.66 to 4.84) and patient satisfaction (N = 390; RR 2.81, 95% CI 1.85 to 4.26) were improved following the administration of dezocine compared with the placebo. The effects of dezocine were similar to those of morphine in terms of the number of patients reporting at least 50% pain relief within 2-6 h after surgery (N = 235; RR 1.29, 95% CI 1.15 to 1.46) and physician (N = 234; RR 1.18, 95% CI 0.93 to 1.49) and patient (N = 158; RR 1.33, 95% CI 0.93 to 1.92) satisfaction. While, the number of patients with at least 50% pain relief within 0-1 h after surgery increased following dezocine compared with morphine treatment (N = 79; RR 1.45, 95% CI 1.18 to 1.77). There was no difference in the incidence of postoperative nausea and vomiting (PONV) following dezocine treatment compared with the placebo (N = 391; RR 1.06, 95% CI 0.42 to 2.68) or morphine treatment (N = 235; RR 0.65, 95% CI 0.14 to 2.93).

Conclusion: Dezocine is a promising analgesic for preventing postoperative pain, but further studies are required to evaluate its safety.

Fig 1. PRISMA flow chart detailing retrieved, excluded, assessed, and included trials.

Fig 2. Forest plot of the effect of dezocine versus placebo on postoperative pain relief (at least 50%) within 6 h after surgery.

RR = relative risk; and CI = confidence interval.

Fig 3. Forest plot of the effects of dezocine versus placebo on physician and patient satisfaction after surgery (A), and postoperative nausea and vomiting (PONV) (B).

RR = relative risk; and CI = confidence interval.

Fig 4. Forest plot of the effect of dezocine versus morphine on the overall evaluation of physician satisfaction after surgery.

RR = relative risk; and CI = confidence interval.

Fig 5. Forest plot of the effects of dezocine versus morphine on physician and patient satisfaction after surgery (A), and postoperative nausea and vomiting (PONV) (B).

RR = relative risk; and CI = confidence interval.