关键词: 吗啡, Meta, 氢吗啡酮, 硬膜外, 镇痛

Abstract: ［Abstract］ Objective To systematically evaluate thepatient controlled epidural analgesia（PCEA） effect between morphine and hydromorphone， so as to provide evidence for clinical application. Methods Databases including the PubMed， Cochrane Library， WanFang Data， and CNKI （by February 2019） were searched for randomized controlled trials （RCTs） involving the PCEA effect between morphine and hydromorphone in adult patients， with no language limit. According to the modified Jadad quality scale， literature was screened， data were extracted， and quality of the included studies was critically evaluated. then meta?analysis was performed using Stata 12.0 software. Results A total of 5 RCTs involving 455 patients were included. The results of meta?analyses showed that： compared with patients in the morphine group， the incidence ofpruritus was lower for patients in the hydromorphone group； neither scores of visual analog scale（VAS） for pain at rest nor VAS scores for pain with movement differed statistically between the two groups. There was no significant difference in the incidence of nausea and vomiting and other side effects between the two groups. Conclusion Compared with morphine， PCEA with hydromorphone has less side effects and is worthy to recommend its clinical use.

Key words: meta?analysis, epidural, morphine, analgesia, hydromorphone