旨在评估使用芬太尼进行牙科围手术期疼痛管理的疗效和不良事件。这项随机临床试验 (RCT) 系统评价遵循 PRISMA 指南，并纳入了各种数据库。对研究 674 名患者的 11 项 RCT 进行了分析。围手术期疼痛主要在接受阻生磨牙手术的患者中进行评估，尽管一些研究也包括患有其他疾病的患者，例如口腔粘膜下纤维化、上颌癌、骨性颞下颌关节强直、不可逆性牙髓炎等。芬太尼与右美托咪定合用可增强镇痛效果。与奈福泮和纳布啡相比，它表现出相当的功效。鼻内和静脉内给药途径被证明同样有效。在四项随机对照试验中，芬太尼透皮贴剂的表现优于对照组，但与罗哌卡因进行比较的临床试验除外。与使用芬太尼相关的主要不良事件包括恶心、呕吐、嗜睡、谵妄和呼吸抑制；然而，它们与对照组中报告的结果相似。虽然芬太尼表现出令人满意的围手术期镇痛效果，但还有其他替代品显示出更好或可比的结果。由于芬太尼的风险和滥用的可能性，尽管也有不良事件的报告，但必须考虑这些替代品。© 2023 Wiley periodicals LLC。

To assess the efficacy and adverse events linked to the utilization of fentanyl for perioperative pain management in dentistry.This systematic review of randomized clinical trials (RCTs) adhered to the PRISMA guidelines and incorporated various databases.Eleven RCTs studying 674 patients were analyzed. Perioperative pain was predominantly evaluated in patients undergoing surgery for impacted molars, although some studies also included patients with other conditions such as oral submucous fibrosis, maxillary cancer, bony temporomandibular joint ankylosis, irreversible pulpitis, among others. Combined with dexmedetomidine, fentanyl produced enhanced analgesic effects. It demonstrated comparable efficacy when compared to nefopam and nalbuphine. Both intranasal and intravenous administration routes proved equally effective. In four RCTs, the transdermal fentanyl patch outperformed the control group, except in the clinical trial where it was compared to ropivacaine. The main adverse events associated with the use of fentanyl included nausea, vomiting, drowsiness, delirium, and respiratory depression; however, they were like those reported in the comparison groups.While fentanyl demonstrated satisfactory perioperative analgesic efficacy, there were other alternatives that displayed better or comparable outcomes. Due to the risks and potential for misuse of fentanyl, these alternatives must be considered although adverse events were also reported.© 2023 Wiley Periodicals LLC.