老年患者地氟烷和七氟烷麻醉后早期恢复情况及认知功能比较：一项随机对照试验的荟萃分析

Comparison of early recovery and cognitive function after desflurane and sevoflurane anaesthesia in elderly patients: A meta-analysis of randomized controlled trials.

作者信息

Chen Gang, Zhou Youfa, Shi Qingyu, Zhou Haiyan

机构信息

Department of Anaesthesia, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Department of Anaesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

J Int Med Res. 2015 Oct;43(5):619-28. doi: 10.1177/0300060515591064. Epub 2015 Jul 31.

DOI:10.1177/0300060515591064

PMID:26232124

Abstract

OBJECTIVES

A meta-analysis to compare postoperative cognitive function and the time to specific recovery events in elderly patients (aged >65 years) anaesthetized with sevoflurane or desflurane.

METHODS

A systematic search of the PubMed(®), Embase(®), Cochrane Library and Chinese Biomedical databases was performed using the keywords 'sevoflurane' and 'desflurane'. Data and characteristics of appropriate randomized controlled trials (RCTs) were extracted.

RESULTS

The meta-analysis included five trials (n = 300). The time taken to follow commands (mean difference [MD] -3.27; 95% confidence intervals [CI] -4.95, -1.59), extubation (MD -1.59; 95%CI -2.62, -0.55), orientation (MD -4.31; 95%CI -4.99, -3.62), and recovery room discharge (MD -9.38; 95%CI -13.43, -5.42) were significantly shorter in the desflurane group than in the sevoflurane group. There was no significant between-drug difference in the incidence of postoperative cognitive dysfunction or the time taken to open the eyes.

CONCLUSIONS

Desflurane is associated with a faster recovery from general anaesthesia than sevoflurane in elderly patients.

摘要

目的

进行一项荟萃分析，比较接受七氟烷或地氟烷麻醉的老年患者（年龄>65岁）术后认知功能及特定恢复事件的发生时间。

方法

使用关键词“七氟烷”和“地氟烷”对PubMed(®)、Embase(®)、Cochrane图书馆和中国生物医学数据库进行系统检索。提取合适的随机对照试验（RCT）的数据和特征。

结果

该荟萃分析纳入了五项试验（n = 300）。地氟烷组患者对指令的反应时间（平均差[MD] -3.27；95%置信区间[CI] -4.95，-1.59）、拔管时间（MD -1.59；95%CI -2.62，-0.55）、定向力恢复时间（MD -4.31；95%CI -4.99，-3.62）和恢复室出院时间（MD -9.38；95%CI -13.43，-5.42）均显著短于七氟烷组。术后认知功能障碍的发生率或睁眼时间在两组药物之间无显著差异。