摘要
目的采用meta分析评价右美托咪定滴鼻对患儿七氟醚全麻苏醒期躁动的影响。方法计算机检索Pubmed、Embase、The Cochrane Library、中国期刊全文数据库、维普、万方数据库,检索时限均为建库至2017年6月。纳入研究右美托咪定滴鼻对患儿七氟醚全麻苏醒期躁动影响的随机对照试验,手工检索纳入文献的参考文献。由两位研究者独立进行资料提取,主要指标:苏醒期躁动发生率和镇静评分,次要结束指标:苏醒时间、气管拔管时间、PACU停留时间、术后镇痛药用量、麻醉恢复期间不良反应(包括心动过缓、恶心呕吐、瘙痒、喉痉挛等)发生率,纳入研究的方法学质量评价后,采用RevMan 5.3软件进行meta分析。结果纳入8项随机对照试验共520例患儿。meta分析结果显示:与安慰剂组相比,右美托咪定滴鼻组躁动发生率降低,镇静评分升高,气管拔管时间延长(P<0.05),PACU停留时间、术后恶心呕吐发生率差异均无统计学意义(P>0.05);0.3~1.0μg/kg右美托咪定滴鼻组苏醒时间延长(P<0.05),1.0~2.0μg/kg右美托咪定滴鼻组苏醒时间差异无统计学意义(P>0.05)。结论右美托咪定滴鼻可降低患儿七氟醚全麻苏醒期躁动的发生,提高苏醒质量。
Objective To systematically evaluate the effect of intranasal dexmedetomidine on agitation during emergence from general anesthesia with sevoflurane in pediatric patients.Methods Pubmed, Embase,The Cochrane Library,China National Knowledge Infrastructure,VIP,Wan-Fang databases were searched for randomized controlled trials involving the effect of intranasal dexmedetomidine on agitation during emergence from general anesthesia with sevoflurane in pediatric patients from the start of their database until June 2017,and the reference lists of all included studies were checked manually.Data were extracted independently by two reviewers,and primary evaluation indexes included the incidence of emergence agitation and sedation score.Secondary evaluation indexes included emergence time,extubation time,duration of post-anesthesia care unit stay,postoperative consumption of analgesics,incidence of adverse reactions (such as bradycardia,nausea and vomiting,pruritus,laryngeal spasm)during recovery from anesthesia.The quality of methodology of included studies was assessed.Meta-analysis was conducted with RevMan 5.3 software.Results Eight randomized eohtrolled trials involving 520 pediatric patients were included in this recta-analysis.Compared with placebo group,the incidence of emergence agitation was significantly decreased,sedation score was increased,extubation time was prolonged (P<0.05),no significant change was found in the duration of post-anesthesia care unit stay or ineidenee of postoperative nausea and vomiting in intranasal dexmedetomidine group (P>0.05).The emergence time was prolonged in intranasal 0.3-1.0 μg/kg dexmedetomidine group (P<0.05),and no significant change was found in emergence time in intranasal dexmedetomidine 1.0-2.0 μg/kg group (P>0.05).Conclusion Intranasal dexmedetomidine can decrease the occurrence of agitation during emergence from general anesthesia with sevoflurane and raise the quality of emergence in pediatric patients.
作者
祝瑜
高鸿
田磊
路凯
佘玉琦
钟毅
Zhu Yu;Gao Hong;Tian Lei;Lu Kai;She Yuqi;Zhong Yi(Department of Ultrasound,Affiliated Renmin Hospital of Hubei University of Medicine,Shiyan 442000, China;Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;Guizhou Anesthesiology Graduate Workstation Department of Anesthesiology,Guizhou Medical University,Guiyang 550004,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2018年第9期1045-1048,共4页
Chinese Journal of Anesthesiology
关键词
右美托咪啶
投药
鼻内
麻醉药
吸入
儿童
META分析
躁动
Dexmedetomidine
Administration,intranasal
Anaesthetie,inhalation
Child
Meta-analysis
Agitation
