Ahn Eun Jin, Kang Hyun, Choi Geun Joo, Baek Chong Wha, Jung Yong Hun, Woo Young Choel
From the Department of Anaesthesiology and Pain Medicine, Inje University, Seoul Paik Hospital, Seoul, Korea; and Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Anesth Analg. 2016 Mar;122(3):664-676. doi: 10.1213/ANE.0000000000001062.
Previous randomized controlled trials regarding the effectiveness of perioperative midazolam in preventing postoperative nausea and vomiting (PONV) have produced conflicting results. Consequently, the present systematic review was performed to assess the effect of perioperative administration of midazolam on PONV.
The MEDLINE®, Embase, and Cochrane Central Register of Controlled Trials databases were searched to identify all randomized controlled trials that investigated the effectiveness of midazolam under general anesthesia. The primary end points were defined as postoperative nausea (PON), postoperative vomiting (POV), and PONV.
From 16 studies, 1433 patients were included in the final analysis. Compared with the control group, patients who received midazolam showed a lower overall incidence of PON (risk ratio [RR], 0.51; 95% confidence interval [CI], 0.40-0.65; I = 35%; number needed to treat [NNT] = 6; number of included studies [n] = 11), POV (RR, 0.46; 95% CI, 0.33-0.65; I = 0%; NNT = 8; n = 10), and PONV (RR, 0.45; 95% CI, 0.36-0.57; I = 31%; NNT = 3; n = 7).
Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.
先前关于围手术期使用咪达唑仑预防术后恶心呕吐（PONV）有效性的随机对照试验结果相互矛盾。因此，进行了本系统评价以评估围手术期给予咪达唑仑对PONV的影响。
检索MEDLINE®、Embase和Cochrane对照试验中心注册库数据库，以识别所有研究咪达唑仑在全身麻醉下有效性的随机对照试验。主要终点定义为术后恶心（PON）、术后呕吐（POV）和PONV。
16项研究中，1433例患者纳入最终分析。与对照组相比，接受咪达唑仑的患者PON总体发生率较低（风险比[RR]，0.51；95%置信区间[CI]，0.40 - 0.65；I² = 35%；需治疗人数[NNT] = 6；纳入研究数量[n] = 11），POV（RR，0.46；95% CI，0.33 - 0.65；I² = 0%；NNT = 8；n = 10），以及PONV（RR，0.45；95% CI，0.36 - 0.57；I² = 31%；NNT = 3；n = 7）。
围手术期给予咪达唑仑可有效预防PON、POV和PONV。
