摘要
目的通过Meta分析比较右美托咪定与曲马多治疗寒战的效果。方法计算机检索2010年1月至2017年12月在PubMed、CENTRAL、Embase、中国知网、万方数据库发表的右美托咪定与曲马多治疗麻醉后寒战的随机对照试验(RCT)。从符合纳入及排除标准文献中提取数据,并采用RevMan 5.3软件进行分析。结果共纳入19篇中英文文献,共计1 366例患者。右美托咪定组与曲马多组治疗寒战的有效率差异无统计学意义(RR=1,95%CI 0.98~1.03,P=0.81);右美托咪定组治疗寒战起效时间明显短于曲马多组(MD=-1.28 min,95%CI-1.89^-0.67 min,P<0.001),寒战复发率明显低于曲马多组(RR=0.26,95%CI 0.13~0.52,P<0.001),恶心、呕吐发生率明显低于曲马多组(RR=0.08,95%CI 0.05~0.13,P<0.001),Ramsay镇静评分明显高于曲马多组(MD=0.97分,95%CI 0.76~1.19分,P<0.001)。结论右美托咪定治疗寒战的有效率与曲马多相似,但右美托咪定治疗寒战起效时间更短,寒战复发率、恶心呕吐发生率更低,镇静效果更好。
Objective To compare the effects of dexmedetomidine and tramadol in the treatment of shivering by meta-analysis. Methods PubMed, CENTRAL, Embase, China Knowledge Network, and Wanfang database were searched from January 2010 through December 2017 to identify studies of the efficacy of dexmedetomidine and tramadol in the treatment of shivering. Data were extracted using the inclusion and exclusion criteria and meta-analysis was performed using RevMan 5.3 software. Results A total of 19 Chinese and English literatures were included for meta-analysis, totaling 1 366 patients. Meta-analysis showed no statistically significant difference in the efficacy of dexmedetomidine versus tramadol in the treatment of shivering(RR=1, 95%CI 0.98 to 1.03, P = 0.81). The dexmedetomidine group had a shorter onset time for the treatment of shivering than the tramadol group(MD=-1.28 min, 95%CI-1.89 to-0.67 min, P < 0.001). The recurrence rate of shivering was lower than that of the tramadol group(RR = 0.26, 95%CI 0.13 to 0.52, P < 0.001). The incidence of nausea and vomiting was lower than that of the tramadol group(RR=0.08, 95%CI 0.05 to 0.13, P < 0.001). The Ramsay sedation score was higher than that of the tramadol group(MD=0.97, 95%CI 0.76 to 1.19, P < 0.001). Conclusion The efficacy of dexmedetomidine and tramadol in the treatment of shivering is similar, but dexmedetomidine has a shorter onset time, lower recurrence rate, lower incidence of nausea and vomiting, and higher sedation effect.
作者
鲁丹
马虹
LU Dan;MA Hong(Department of Anesthesiology, the First Affiliated Hospital of China Medi cal University, Shenyang 110000,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2019年第9期897-902,共6页
Journal of Clinical Anesthesiology
