[±¹¿Ü AHRQ ÃֽŠ¿¬±¸µ¿Çâ : ±Þ¼ºÅëÁõÄ¡·á]
Treatment for Acute Pain: An Evidence Map
¿¬±¸¸ñÀû
-±Þ¼ºÅëÁõ¿¡ ´ëÇÑ ¾à¹°Àû ºñ¾à¹°Àû Ä¡·á¿¡ ´ëÇÑ Ã¼°èÀû °íÂûÀ» ÅëÇÏ¿© »óÀ§¼öÁØÀÇ °íÂûÀ» ÅëÇÑ evidence-map Á¦°øÇϱâ À§ÇÔ.
±Þ¼ºÅëÁõÀº ¼ö¼ú ÈÄ ÅëÁõ, Ä¡°úÅëÁõ, ¸ñÅëÁõ, ¿äÅë, ½Å»êÅë(postoperative pain, dental pain, neck pain, back pain, renal colic, acute migraine, and sickle cell crisis)µîÀ» Æ÷ÇÔÇÑ´Ù.
¿¬±¸¹æ¹ý
-MEDLINE, Cochrane Library: 2016³â 1¿ùºÎÅÍ 2018³â 9¿ù
- ¼±Á¤±âÁØ(eligibility criteria):
1. ¿µ¾î ¿ø¹® °¡´ÉÇÑ ÀÚ·á
2. 2016³â ÀÌ ÈÄ ¹ßÇ¥µÈ ÀÚ·á
3. ºñ¶Ô¸²°ú ÁúÆò°¡¸¦ ÅëÇØ ÃÖ¼Ò ¹ÙÀ̾ È®ÀÎµÈ ÀÚ·á
(Sufficient quality (proxy: assessed and reported risk of bias for each included study)
4. ÀÏÂ÷ÀûÀÎ ¿¬±¸¸ñÀûÀÌ ¼±ÅÃµÈ ±Þ¼º ÅëÁõÄ¡·á¿¡ ±âÀÎÇÑ ¿¬±¸ ÀÚ·á
(Focused primarily on pain treatments attributable to selected acute pain conditions)
5. ºñ¾à¹°Àû Ä¡·áÀÇ ½ÇÇ迬±¸¸¦ Æ÷ÇÔÇϰųª FDA½ÂÀÎµÈ ¾à¹°Ä¡·á
(Included trials of any nondrug therapy or FDA-approved drugs (for any condition)
ÁÖÁ¦ : ±Þ¼ºÅëÁõÀÇ ¾à¹°Àû, ºñ¾à¹°Àû Ä¡·á
(Pharmacologic and Nonpharmacologic treatments for Acute pain)
Guiding Questions (GQ)
Acute Pain Conditions and Settings (GQ1)
GQ1: ´ÙÀ½°ú °°Àº ±¸Ã¼ÀûÀΠƯÁ¤ ÀÇ·á½Ã¼³(ÀÀ±Þ½Ç, ÀÔ¿ø ȯÀÚ ¹× ¿Ü·¡ ȯÀÚ ¼ö¼ú½Ç, 1 Â÷ ÀÇ·á±â°ü ¹× Àü¹® Áø·á¼Ò, Ä¡°ú Áø·á¼Ò ¹× Ä¡°ú ¼ö¼ú ¼¾ÅÍ)¿¡¼ °¡Àå ÀϹÝÀûÀ¸·Î Ä¡·áµÇ´Â ±Þ¼º ÅëÁõ »óÅ´ ¹«¾ùÀԴϱî?
a. ÀÌ·¯ÇÑ »óÅ¿¡ ´ëÇÑ ±Þ¼º ÅëÁõÀº ¾î¶»°Ô Æò°¡µÇ°í ¸ð´ÏÅ͸µµË´Ï±î?
b. ÅëÁõ ÁßÁõµµ, Ä¡·á ¿É¼Ç ¹× Ä¡·á ¹ÝÀÀ¿¡ ´ëÇÑ ÀνÄÀ» ¼öÁ¤ÇÏ´Â °³º°Àû Ư¼ºµéÀº ¹«¾ùÀԴϱî?
Literature Search Results (GQ2 to GQ4)
GQ 2. ÀÌ·¯ÇÑ Áß¿äÇÑ ±Þ¼º ÅëÁõ»óÅ Áß¿¡¼ ¾î¶² °ÍÀÌ ±Þ¼º ÅëÁõ Ä¡·á¸¦ ´Ù·ç´Â ÃÖ±Ù ¹ßÇ¥µÈ °íÇ°Áú Áöħ(high-quality guidelines)À» °¡Áö°í ÀÖ½À´Ï±î?
—> ÀÌ·¯ÇÑ ½É°¢ÇÑ ÅëÁõ »óŵé Áß¿¡¼ ±Þ¼ºÅëÁõ Ä¡·á¿¡ ´ëÇØ ÁúÀûÀ¸·Î ½Å·ÚÇÒ ÇÑ ÃÖ±Ù ÀÓ»ó°¡À̵å¶óÀεéÀÌ ÀÖ½À´Ï±î?
GQ 3. ´ÙÀ½ Áß ±Þ¼º ÅëÁõ Ä¡·á¸¦ Æò°¡ÇÏ´Â ÃÖ±ÙÀÇ ÁúÀûÀ¸·Î ³ôÀº ¼öÁØÀÇ Ã¼°èÀû °íÂûÀÌ ÀÖ´Â ±Þ¼º ÅëÁõ »óÅ´ ¹«¾ùÀԴϱî?
a. ¾î¶² Àα¸Áý´Ü, ±Þ¼º ÅëÁõ»óÅ ¹× Ä¡·á°¡ ü°èÀûÀ¸·Î ÃæºÐÈ÷ °ËÅä µÇ¾ú½À´Ï±î?
B. ü°èÀûÀÎ °íÂû¿¡¼ ¾î¶°ÇÑ Áõ°ÅµéÀÇ °ÝÂ÷°¡ È®ÀÎ µÇ¾ú½À´Ï±î?
GQ 4. ÃÖ±ÙÀÇ °íÇ°Áú ü°èÀû °ËÅä¾øÀÌ ¿ì¼± ¼øÀ§ ±Þ¼º ÅëÁõ »óÅ¿¡ ´ëÇÑ ±Þ¼º ÅëÁõ Ä¡·á¸¦ Æò°¡ÇÒ ¼öÀÖ´Â 1Â÷ ºñ±³ È¿°ú ¿¬±¸ÀÚ·á°¡ °¡´ÉÇմϱî?
a. ¾î¶² Àα¸¿Í ȯ°æÀ» ¿¬±¸ Çß½À´Ï±î?
Key result summary
1.ÅëÁõÀ» Ä¡·áÇϱâ À§ÇØ ºñ ¾à¹° ÁßÀ縦 Æ÷ÇÔÇÑ ¸ðµç ÀáÀçÀû ÁßÀç¿¡ ´ëÇÑ Æ÷°ýÀûÀÌ°í ¾ö°ÝÇÑ Æò°¡¸¦ Á¦°øÇϴ ü°èÀûÀÎ °íÂûÀº °ÅÀÇ ¾ø½À´Ï´Ù.
2. Á¾ÇÕÀûÀΠü°èÀûÀÎ °íÂû ¶Ç´Â ü°èÀûÀÎ °íÂûÀÇ ¿ä¾àÀÌ ÇÊ¿äÇÒ ¼ö ÀÖ´Â ±Þ¼º ÅëÁõ »óÅ¿¡´Â ¼ö¼ú ÈÄ Åð¿ø ÈÄ ÅëÁõ, ±Þ¼º ¿äÅë, ±Þ¼º ¸ñ ÅëÁõ, ½ÅÀå »êÅë ¹× ±Þ¼º ÆíµÎÅë(postoperative postdischarge pain, acute back pain, acute neck pain, renal colic, and acute migraine)ÀÌ Æ÷ÇԵ˴ϴÙ.
3. ÀϺΠ±Þ¼º ÅëÁõ »óÅÂ(¼ö¼ú ÈÄ ÅëÁõ, Ä¡°ú ½Ã¼ú ¹× ±¸° ¼ö¼ú°ú °ü·ÃµÈ ÅëÁõ, ¿äÅë, ±Þ¼º ÆíµÎÅë)¿¡´Â °ü·ÃµÈ ü°èÀûÀÎ ¸®ºä°¡ ¸¹ÀÌ ÀÖ½À´Ï´Ù. Ä¡°ú ÀýÂ÷ ¹× ±¸° ¼ö¼ú, ¿äÅë, ½ÅÀå »êÅë, ±Þ¼º ÆíµÎÅë°ú °ü·ÃµÈ ÅëÁõ ÁÖÁ¦°ü·ÃÇؼ »õ·Î¿î ü°èÀû °íÂûÀ» ÇÒ ¼ö ÀÖ´Â ÃæºÐÇÑ »õ·Î¿î ÀÚ·á°¡ ÀÖ½À´Ï´Ù.
4. ¸Å¿ì ´Ü±âÀûÀÎ °á°ú¸¦ Á¦¿ÜÇÏ°í ±Þ¼ºÅëÁõ Ä¡·áÀÇ È¿°ú¸¦ °ËÁõÇÑ Ã¼°èÀû °íÂûÀº °ÅÀÇ ¾øÀ¾´Ï´Ù. ÅëÁõÀÌ ÃË¹ßµÈ »ç°ÇÀÌÈÄ ÁÖ ¶Ç´Â ¿ù µ¿¾ÈÀÇ ÅëÁõ°ú Áö¼ÓÀûÀÎ ÁøÅëÁ¦ ¿ÀÇÇ¿ÀÀ̵å»ç¿ë¿¡ ´ëÇؼ º¸°í µÈ °ÍÀº °ÅÀÇ ¾ø½À´Ï´Ù.
5. ´ëºÎºÐÀÇ Ã¼°èÀûÀÎ °íÂûÀº ÅëÁõ °µµ¸¸À» ÃøÁ¤Çϴ ôµµ¸¦ »ç¿ëÇÏ¿© ÅëÁõ °á°ú¸¦º¸°íÇÏ¿´°í, ±â´ÉÀ̳ª ±âŸ ÅëÁõ Ư¼º¿¡ ´ëÇÑ Ã¼°èÀû °íÂû ¿¬±¸´Â °ÅÀÇ ¾ø½À´Ï´Ù.
6. ÀÏ¹Ý ¼ºÀÎÀ̳ª ¾î¸°ÀÌ ¹× û¼Ò³â ÀÌ¿ÜÀÇ Æ¯Á¤ ȯ°æÀ̳ª Àα¸Áý´Ü¿¡ ÁßÁ¡À» µÐ ¸®ºä´Â °ÅÀÇ ¾ø½À´Ï´Ù.
Discussion:
Ãß°¡ÀûÀÎ ÀÏÂ÷ ¿À¸®Áö³Î ¿¬±¸¿Í ¾÷µ¥ÀÌÆ®µÈ Á¾ÇÕÀûÀΠü°èÀû °íÂû¿¬±¸°á°úµéÀº ±¤¹üÀ§ÇÏ°í ´Ù¾çÇÑ ±Ý¼ºÅëÁõ»óÅ ġ·á°áÁ¤¿¡ µµ¿òÀ» ÁÙ ¼ö ÀÖ½À´Ï´Ù.
Reference
Suggested citation: Brasure M, Nelson VA, Scheiner S, Forte ML, Butler M, Nagarkar S, Saha J, Wilt TJ. Treatment for Acute Pain: An Evidence Map. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-2015-0000-81) AHRQ Publication No.19(20)-EHC022-EF. Rockville, MD: Agency for Healthcare Research and Quality; October 2019. Posted final reports are located on the Effective Healthcare Program search page. DOI: https://doi.org/10.23970/AHRQEPCTB33.