摘要
目的系统评价分析氨茶碱用于全麻术后催醒的有效性及可行性。方法计算机检索Cochrane图书馆、MEDLINE、CNKI、VIP及CBM(从建库至2015年6月),收集所有氨茶碱用于全麻术后催醒的随机对照试验(RCT),使用Cochrane系统评价方法对纳入研究进行质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入14个RCT,包括1055例患者。Meta分析结果显示:①苏醒时间:氨茶碱与空白对照组比较能明显缩短全麻术后睁眼时间、拔管时间和听从指令时间『分别为WMD=-1.85,95%CI(-2.59,-1.12),P<0.01;WMD=-1.98,95%CI(-2.34,-1.62),P<0.01;WMD=-3.06,95%CI(-3.80,-2.32),P<0.01],效果与多沙普仑相当[分别为WMD=1.59,95%CI(-0.33,3.60),P>0.05;WMD=0.72,95%CI(-0.53,1.96),P>0.05;WMD=1.09,95%CI(-1.02,3.20),P>0.05],听从指令时间优于毒扁豆碱[WMD=-6.91,95%CI(-10.17,-3.65),P<0.01];②BIS值:氨茶碱与空白对照组比较能明显提高全麻苏醒期BIS值(P<0.05),与多沙普仑相当(P>0.05);③不良事件:与空白对照组比较,氨茶碱不增加术后寒战、烦躁、恶心、呕吐、心律失常发生率(P>0.05),术后躁动发生率少于毒扁豆碱组及纳洛酮组[RR=6.0,95%CI(1.94,18.55),P<0.05;RR=0.09,95%CI(0.01,0.68),P<0.05]。结论现有研究表明,氨茶碱能有效缩短全麻术后苏醒时间,不增加术后不良事件发生,是一种安全有效的全麻催醒药物。但限于纳入研究方法学质量上的局限性,本系统评价结果尚需更多高质量的RCT进一步验证。
Objective This meta-analysis aimed to systematically collect the current evidence regarding the efficacy and safety of aminophylline for cognitive recovery from general anesthesia.Methods Randomized controlled trials（RCTs） were searched in The Cochrane Library,Medline,CNKI,VIP,CBM up to June 2015,The methodological quality of the included literatures were evaluated,and meta-analyses were performed with The Cochrane Collaboration＇s RevMan 5.0 software.Results A total of 14 RCTs involving 1055 patients were included.The results of meta-analyses showed;①Recovery times：Aminophylline significantly shorten the times to eye open,extubation and response to com mand[WMD=-1.86,95%CI（-2.59,-1.12）.P〈0.01;WMD=-1.98,95%67（-2.34,-1.62）,P〈0.01;WMD=-3.06,95%C/（-3.80.-2.32）,P〈0.01;respectively],which similar to Doxapram[WMD=1.59,95%CI（-0.33,3.60）,P〉0.05;WMD=0.72,95%CI（-0.53,1.96）,P〉0.05;WMD=1.09,95%CI（-1.02,3.20）,P〉0.05 respectively],and better than Physostigmine in response to command time[WMD=-6.91,95%CI（-10.17,-3.65）,P〈0.01];②BIS values：Aminophylline significantly increased the BIS values（P〈0.05）,which also similar to Doxapram（P〉0.05）;③Adverse events：Compared with the control group,Aminophylline could not increase the incidences of postoperative shivering,irritability,nausea,vomiting and arrhythmia（P〉0.05）,the incidence of postoperative agitation was even significantly reduced as compared with Physostigmine and Naloxone[RR=6.0,95%CI（1.94,18.55）,P〈0.01;RR=0.09,95%CI（0.01,0.68）,P〈0.05;respectively].Conclusion Aminophylline is a safe and effective analeptic for cognitive recovery from general anesthesia both in recovery times and BIS values,and do not increase the adverse events.However,because of the limited quality of the included studies,further verification with more high quality RCTs are needed.
出处
《中国现代医生》
2015年第32期128-133,共6页
China Modern Doctor
基金
浙江省卫生厅科研基金资助项目(2012RCA045)
关键词
氨茶碱
全麻
催醒
随机对照试验
系统评价
Aminophylline
General anesthesiaz
Recovery
Randomized controlled trial
Systematic review
