Pain, as a complex physiological and pathological phenomenon, has always been a hot topic in medical research in terms of its mechanism of occurrence and influencing factors. Vitamin D, as a fat soluble vitamin, has been shown to be closely associated with pain in recent years, in addition to its classic role in regulating calcium and phosphorus metabolism. The polymorphism of the vitamin D receptor (VDR) gene can lead to changes in the structure and function of VDR, thereby affecting vitamin D levels. Meanwhile, VDR gene polymorphism can indirectly or directly participate in the occurrence and development of pain. This article aims to review the research on the relationship between vitamin D and its receptor gene polymorphism and pain, and provide reference for potential therapeutic targets and personalized intervention strategies for pain.
ObjectivesTo systematically review the efficacy of lidocaine injected prior to tracheal extubation in preventing hemodynamic responses to tracheal extubation in general anesthesia.MethodsPubMed, Ovid, Web of Science, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of lidocaine administrated prior to extubation in preventing hemodynamic responses to tracheal extubation in patients undergoing general anesthesia from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 13.0 software.ResultsA total of 10 RCTs involving 525 patients were included. The results of meta-analysis showed that: compared with control group, lidocaine could reduce mean arterial pressure in 5 min after extubation (MD=–5.10, 95%CI –9.41 to –0.79, P=0.02), weaken the increase in systolic blood pressure caused by extubation from the moment before extubation to 5 minutes after extubation (before extubation: MD=–7.22, 95%CI –10.34 to –4.11, P<0.000 01; at extubation: MD=–14.02, 95%CI –19.42 to –8.62, P<0.000 01; 1 minutes after extubation: MD=–15.82, 95%CI –22.20 to –9.45, P<0.000 01; 3 minutes after extubation: MD=–12.55, 95%CI –20.36 to –4.74, P=0.002; and 5 minutes after extubation: MD=–12.05, 95%CI –20.35 to –3.74, P=0.004), and weakened extubation-induced increase in diastolic blood pressure at extubation (MD=–9.71, 95%CI –16.57 to –2.86, P=0.005). In addition, lidocaine inhibited heart rate in all time points except the moment of before and at 10 minutes after extubation.ConclusionsCurrent evidence shows that lidocaine can inhibit the increase in blood pressure and heart rate caused by extubation at certain times. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.