Pace N L
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City 84132.
Anesth Analg. 1990 May;70(5):477-83. doi: 10.1213/00000539-199005000-00002.
Meta-analysis is a term used to describe statistical methods for evaluating a series of research reports; this analysis transcends the limitations that may be inherent in each of the individual studies summarized. Forty-five research reports of clinical trials for the prevention of myalgias after succinylcholine were assembled. Four classes of preventive drugs (nondepolarizing muscle relaxants, benzodiazepines, succinylcholine in "self-taming" doses, and local anesthetics) were reported in detail sufficient to allow for inclusion in a meta-analysis of clinical efficacy. Each study was summarized by determining the difference in the incidence of myalgias on the first postoperative day between treatment and control groups. A random-effects variance components approach was used. Seven meta-analyses were performed (atracurium, d-tubocurarine, gallamine, pancuronium, diazepam, succinylcholine in self-taming doses, and lidocaine). For each meta-analysis there was statistically significant heterogeneity among studies. Atracurium, d-tubocurarine, gallamine, pancuronium, diazepam, and lidocaine all significantly decreased the frequency of myalgias by about 30%. Succinylcholine in self-taming doses alone was not efficacious.
荟萃分析是一个用于描述评估一系列研究报告的统计方法的术语；这种分析超越了所总结的每项个体研究可能固有的局限性。收集了45篇关于预防琥珀酰胆碱后肌痛的临床试验研究报告。详细报告了四类预防药物（非去极化肌松药、苯二氮䓬类药物、“自我驯化”剂量的琥珀酰胆碱和局部麻醉药），足以将其纳入临床疗效的荟萃分析。通过确定治疗组和对照组术后第一天肌痛发生率的差异来总结每项研究。采用随机效应方差成分法。进行了七项荟萃分析（阿曲库铵、右旋筒箭毒碱、加拉明、泮库溴铵、地西泮、“自我驯化”剂量的琥珀酰胆碱和利多卡因）。对于每项荟萃分析，各研究之间存在统计学上显著的异质性。阿曲库铵、右旋筒箭毒碱、加拉明、泮库溴铵、地西泮和利多卡因均使肌痛频率显著降低约30%。仅“自我驯化”剂量的琥珀酰胆碱无效。
