摘要
目的评价右美托咪定在剖宫产产妇中的麻醉效果及安全性。方法计算机检索Cochrane Library,EMBASE,Pub Med数据库(建库至2019年2月),由2名作者根据纳入和排除标准独立筛选右美托咪定在剖宫产产妇中应用的相关文献并提取资料。对照组措施为蛛网膜下腔阻滞(腰麻)或者腰麻-硬膜外联合麻醉(腰硬联合麻醉)应用布比卡因,或布比卡因联合芬太尼。观察组在对照组基础上加用右美托咪定。分析右美托咪定在剖宫产产妇中应用的麻醉效果及安全性。结果共纳入6项研究402例剖宫产产妇,结果显示观察组感觉阻滞平面达峰时间短于对照组(均数差=-0. 54,95%置信区间:-1. 05^-0. 03,P=0. 04),感觉阻滞持续时间长于对照组(均数差=64. 15,95%置信区间:49. 11~79. 20,P <0. 01),镇静率高于对照组,术后首次疼痛发作时间与对照组比较显著延后,术后疼痛、恶心呕吐、术后寒战及发热发生率低于对照组(均P <0. 05)。结论剖宫产产妇腰麻或腰硬联合麻醉基础上加用右美托咪定临床获益更多,且安全性较好。
Objective To evaluate the anesthetic efficacy and safety of dexmedetomidine in cesarean section.Methods The search terms"dexmedetomidine"and"cesarean section"were searched by the computer in the Cochrane Library,EMBASE,and PubMed databases,from the time of library construction to February 2019.In the control group,bupivacaine or bupivacaine combined with fentanyl were used for subarachnoid block(lumbar anesthesia)or combined spinal epidural anesthesia(lumbar epidural anesthesia).In the observation group,dexmedetomidine was added on the basis of the control group.The efficacy and safety of dexmedetomidine on the basis of spinal anesthesia or combined spinal epidural anesthesia were analyzed.Results A total of 402 parturients were included in 6 studies.The results showed that the peak time of sensory block plane in observation group was shorter than that in control group[mean difference(MD)=-0.54,95%confidence interval(CI):-1.05 to-0.03,P=0.04];the duration of sensory block was longer than that in control group(MD=64.15,95%CI:49.11-79.20,P<0.01);the sedation rate was higher than that in control group;the incidences of postoperative pain,nausea and vomiting,postoperative shivering and fever were lower than those in control group(all P<0.05).Conclusion The clinical efficacy of dexmedetomidine on the basis of combined spinal anesthesia or spinal epidural anesthesia in cesarean delivery women is good.
作者
方爱莉
李岩
路桂军
马骏
Fang Aili;Li Yan;Lu Guijun;Ma Jun(Department of Anesthesiology,Shanxi Academy of Medical Sciences,Shanxi Bethune Hospital,Taiyuan 030032,China;Anesthesia Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Pain,Beijing Tsinghua Changgeng Hospital,Beijing 102218,China)
出处
《中国医药》
2020年第7期1088-1092,共5页
China Medicine
基金
国家自然科学基金(81800765)
中国博士后科学基金资助项目(2019M650769)
北京市博士后工作经费资助项目(2018-ZZ-108)
北京市医院管理局重点医学专业发展计划(ZYLX201810)。
