Kranke Peter, Morin Astrid M, Roewer Norbert, Wulf Hinnerk, Eberhart Leopold H
Department of Anesthesiology, University of Würzburg, Josef-Schneider-Strasse 2, D-97080 Würzburg, Germany.
Anesth Analg. 2002 Jul;95(1):133-43, table of contents. doi: 10.1097/00000539-200207000-00024.
The role of scopolamine administered via transdermal therapeutic systems in the prevention of postoperative vomiting, nausea, and nausea and vomiting is unclear. We performed a systematic search for full reports of randomized comparisons of transdermal scopolamine with inactive control. Dichotomous data were extracted. In the meta-analysis, relative risks and numbers-needed-to-treat/harm were calculated with 95% confidence intervals (CI). In 23 trials, 979 patients received transdermal scopolamine, and 984 patients received placebo. Sensitivity analyses were performed using restricted data for truncated control event rates (40%-80%) and for large trials. With these data, the relative risks for postoperative vomiting (five reports), nausea (five reports), nausea and vomiting (eight reports), and rescue treatment (three reports) were 0.69 (95% CI, 0.58-0.82), 0.69 (95% CI, 0.54-0.87), 0.76 (95% CI, 0.66-0.88), and 0.68 (95% CI, 0.54-0.85), respectively. This means that of 100 patients who receive transdermal scopolamine, approximately 17 will not experience postoperative vomiting who would have done so had they all received a placebo. However, 18 of 100 patients will have visual disturbances, eight will report dry mouth, two will report dizziness, one will be classified as being agitated, and 1-13 patients who are prescribed transdermal scopolamine will not use it correctly. The timing of application does not alter efficacy.
Of 100 patients who receive transdermal scopolamine, approximately 17 will not vomit in the postoperative period who would have done so had they all received a placebo. However, 18 of 100 patients will have visual disturbances, and eight will report dry mouth. Incorrect use further limits its efficacy.
经皮治疗系统给药的东莨菪碱在预防术后呕吐、恶心以及恶心和呕吐方面的作用尚不清楚。我们对东莨菪碱经皮给药与无活性对照进行随机比较的完整报告进行了系统检索。提取了二分数据。在荟萃分析中，计算了相对风险以及治疗所需人数/伤害人数，并给出95%置信区间（CI）。在23项试验中，979例患者接受了东莨菪碱经皮给药，984例患者接受了安慰剂。使用截断对照事件发生率（40%-80%）的受限数据以及大型试验数据进行了敏感性分析。根据这些数据，术后呕吐（5份报告）、恶心（5份报告）、恶心和呕吐（8份报告）以及补救治疗（3份报告）的相对风险分别为0.69（95%CI，0.58-0.82）、0.69（95%CI，0.54-0.87）、0.76（95%CI，0.66-0.88）和0.68（95%CI，0.54-0.85）。这意味着，每100例接受东莨菪碱经皮给药的患者中，约有17例不会经历术后呕吐，而如果他们都接受安慰剂则会呕吐。然而，每100例患者中有18例将出现视觉障碍，8例将报告口干，2例将报告头晕，1例将被归类为烦躁不安，并且1-13例开具东莨菪碱经皮给药处方的患者将不能正确使用。给药时间不改变疗效。
每100例接受东莨菪碱经皮给药的患者中，约有17例在术后不会呕吐，而如果他们都接受安慰剂则会呕吐。然而，每100例患者中有18例将出现视觉障碍，8例将报告口干。使用不当会进一步限制其疗效。
