摘要
目的通过Meta分析方法探讨右美托咪定对脊柱手术术中唤醒的安全性及有效性。方法检索PubMed、EMbase、Web of Science、中国生物医学文献数据库(CBM)和中国期刊全文数据库(CNKI)等自建库以来发表的关于右美托咪定对脊柱手术术中唤醒效果影响的随机、安慰剂对照临床试验。采用RevMan 5.3软件对纳入研究进行Meta分析。结果共纳入文献14篇,共计696例患者,其中右美托咪定组348例,对照组348例。Meta分析结果显示,两组术中唤醒时间差异无统计学意义[均数差(mean deviation,MD)=0.18,95%CI:-0.27~0.36,P=0.44],但右美托咪定组唤醒质量明显更优[相对危险度(relative risk,RR)=2.02,95%CI:1.58~2.68,P<0.001;RR=1.69,95%CI:1.30~2.21,P<0.001],且MAP及心率在唤醒期时也低于对照组(MD=-13.39,95%CI:-18.20~8.58,P<0.01;MD=-14.53,95%CI:-17.44~11.61,P<0.01)。结论右美托咪定不延长脊柱手术术中唤醒时间,有利于提高术中唤醒质量,维持唤醒期间血流动力学稳定。但由于各种偏倚的存在,本结果尚需更多的高质量研究来证实。
Objective To explore the safety and effectiveness of dexmedetomidine in intraoperative wake-up during spinal surgery.Methods We searched PubMed,EMbase,Web of Science,Chinese biomedical database(CBM)and China national knowledge infrastructure(CNKI)for clinical randomized controlled trials about the effects of dexmedetomidine on intraoperative wake-up during spinal surgery.RevMan 5.3 software was used for Meta analysis of the included studies.Results Fourteen randomized controlled trials involving 696 patients were included in the Meta-analysis study.The patients were divided into two groups:a dexmedetomidine group(n=348)and a control group(n=348).Results showed that no significant difference in wake-up time was found between two groups[mean deviation(MD)=0.18,95%CI:-0.27-0.36,P=0.44].However,compared with the control group,the dexmedetomidine group presented substantially improvement in wake-up quality[relative risk(RR)=2.02,95%CI:1.58-2.68,P<0.001.RR=1.69,95%CI:1.30-2.21,P<0.001],and lower MAP and HR levels at wake-up time[MD=-13.39,95%CI:-18.20-8.58,P<0.01.MD=-14.53,95%CI:-17.44-11.61,P<0.01].Conclusions Dexmedetomidine can not prolong wake-up time and may contribute to improvement in wake-up quality and maintain hemodynamic stability during wake-up period in spinal surgery.However,due to the existence of various biases,more high quality studies are needed to confirm the results.
作者
张健
涂青
钱江
郑传东
甘建辉
Zhang Jian;Tu Qing;Qian Jiang;Zheng Chuandong;Gan Jianhui(Center of Anaesthesia Surgery,Sichuan Provincial Hospital for Women and Children,Affiliated Women and Children′s Hospital of Chengdu Medical College,Chengdu 610045,China;Department of Anesthesiology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China;Department of Anesthesiology,Zhejiang Hospital,Hangzhou 310030,China;Department of Anesthesiology,the Third People′s Hospital of Chengdu 610031,China;Department of Anesthesiology,Tangshan People′s Hospital,Tangshan 063000,China)
出处
《国际麻醉学与复苏杂志》
CAS
2019年第10期944-950,共7页
International Journal of Anesthesiology and Resuscitation
基金
四川省卫计委科研课题普及应用项目(18PJ181)
成都市卫计委研究课题(2018002)
浙江省医药卫生科研面上项目(2018KY001)。
