这项系统回顾和荟萃分析旨在盘点慢性非癌性疼痛中受逐渐减量影响的所有结果指标，并研究逐渐减量的有效性。通过 PubMed、Web of Science、SCOPUS 在 MEDLINE 上进行了从开始到 2024 年 4 月的文献检索、EMBASE 和 PsycINFO。最初的数据库搜索确定了 3969 篇文章，这些文章由两名独立审稿人筛选。评估患有慢性非癌性疼痛的成人止痛药逐渐减少的研究符合纳入条件。系统评价和荟萃分析分别纳入了 57 篇和 34 篇文章。偏倚风险评估分别在 30 项、24 项和 3 项研究中显示质量较差、一般和良好。根据 28 项研究的报告，疼痛强度是报告最多的结果指标。此外，还进行了随机效应三水平荟萃分析。发现总体效应大小为 0.917（95% 置信区间 0.61-1.22；P<0.001），表明逐渐减少的有益效果。此外，在逐渐减少疼痛强度、头痛残疾、每月头痛天数、焦虑、抑郁、每月服用的药片数量、每月服用药物的天数、灾难性疼痛方面，显示出统计学上显着的改善。和疼痛干扰。对于身体机能、心理健康相关的生活质量、阿片类药物的使用、疼痛自我效能和身体健康相关的生活质量，没有观察到统计学上的显着影响。这项系统评价揭示了受逐渐减少影响的广泛结果指标。由于纳入文章的偏倚风险较高，必须谨慎解释本荟萃分析的结果。CRD42023416343 (PROSPERO)。版权所有 © 2024 英国麻醉杂志。由爱思唯尔有限公司出版。保留所有权利。

This systematic review and meta-analysis aimed to inventory all outcome measures that are affected by tapering in chronic noncancer pain and to investigate the effectiveness of tapering.A literature search was conducted from inception to April 2024 in MEDLINE via PubMed, Web of Science, SCOPUS, EMBASE, and PsycINFO.The initial database search identified 3969 articles, which were screened by two independent reviewers. Studies evaluating pain medication tapering in adults with chronic noncancer pain were eligible for inclusion. In total, 57 and 34 articles were included in the systematic review and meta-analysis, respectively. Risk of bias assessment demonstrated poor, fair, and good quality in 30, 24, and three studies, respectively. Pain intensity was the most reported outcome measure, as reported in 28 studies. Furthermore, a random-effect three-level meta-analysis was performed. An overall effect size of 0.917 (95% confidence interval 0.61-1.22; P<0.001) was found, indicating a beneficial effect of tapering. In addition, a statistically significant improvement was demonstrated after tapering for pain intensity, headache disability, the number of headache days per month, anxiety, depression, the number of pills consumed per month, the number of days with medication intake per month, pain catastrophising, and pain interference. No statistically significant effect was observed for physical functioning, mental health-related quality of life, opioid use, pain self-efficacy, and physical health-related quality of life.This systematic review revealed a broad range of outcome measures affected by tapering. Owing to the high risk of bias of the included articles, the results of this meta-analysis must be interpreted with caution.CRD42023416343 (PROSPERO).Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.