摘要
目的采用meta分析评价预防性使用丙泊酚对患儿七氟烷麻醉苏醒期躁动的影响。方法利用计算机检索PubMed、Web of Science、Embase、Cochrane Library、ClinicalTrials.gov、中国知网、万方数据库、维普数据库,纳入比较预防性使用丙泊酚(1 mg/kg)与生理盐水对患儿七氟烷麻醉苏醒期躁动影响的临床随机对照试验,检索时间为建库至2020年12月1日。评价指标包括躁动发生率、小儿麻醉苏醒期躁动(PAED)评分、苏醒时间、麻醉后恢复室(PACU)停留时间、术后恶心呕吐(PONV)发生率和除外PONV的不良反应发生率。按照Cochrane风险偏倚评估工具评价纳入文献质量,采用RevMan 5.3和Stata 12.0软件进行meta分析。结果共纳入16项随机对照试验,共1061例患儿,531例患儿注射丙泊酚,530例患儿注射生理盐水。与生理盐水组比较,丙泊酚组患儿苏醒期躁动发生率和PAED评分降低(P<0.05),2组患儿PONV和除外PONV的不良反应发生率及术后PACU停留时间差异无统计学意义(P>0.05)。结论预防性使用丙泊酚(1 mg/kg)可减轻患儿七氟烷麻醉苏醒期躁动程度并降低其发生风险,且不增加术后不良反应的发生。
Objective To systematically review the effect of prophylactic use of propofol on emergence agitation(EA)following sevoflurane anesthesia in pediatric patients.Methods Databases such as Pubmed,Web of Scince,Embase,Cochrane Library,ClinicalTrials.gov,CNKI,Wanfang Data and VIP were searched for randomized controlled trials involving the comparison of effects of propofol(1 mg/kg)versus normal saline on EA following sevoflurane anesthesia in pediatric patients using computers from inception to December 1,2020.Evaluation indexes included incidence of agitation,Pediatric Anesthesia Emergence Delirium(PAED)scale,awakening time,postanesthesia care unit(PACU)stay time and incidence of adverse events.The Cochrane Collaboration′s tool for assessing risk of bias was used to evaluate the quality of the included trials.The meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results Sixteen randomized controlled clinical trials involving 1061 patients were included in this meta-analysis.The patients were divided into 2 groups:propofol group(n=531)and normal saline group(n=530).Compared with group normal saline,incidence of EA and PAED score were significantly decreased in group propofol(P<0.05),and there was no significant difference in the incidence of postoperative nausea and vomiting,incidence of other adverse events and PACU stay time between the 2 groups(P>0.05).Conclusion Prophylactic dose of propofol(1 mg/kg)for sevoflurane-based anesthesia can reduce the degree of EA and decrease its incidence without increasing the occurrence of adverse reactions in pediatric patients.
作者
邢文彦
包特博沁
郭念玫
乌兰格日勒
Xing Wenyan;Bao Tuvshin;Guo Nianmei;Ulan-grille null(Department of Anesthesiology,Inner Mongolia Maternal and Child Health Hospital,Hohhot 010021,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2021年第7期802-808,共7页
Chinese Journal of Anesthesiology
