Zhang Fan, Sun Hao-Rui, Zheng Ze-Bing, Liao Ren, Liu Jin
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Department of Pediatrics, Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China.
Exp Ther Med. 2016 Jun;11(6):2519-2524. doi: 10.3892/etm.2016.3186. Epub 2016 Mar 24.
Patients undergoing endoscopy frequently require sedation, which commonly includes the administration of midazolam or dexmedetomidine. Previous meta-analyses have mainly focused on comparing the effects of these two drugs in intensive care unit patients. In the present study, randomized controlled trials (RCTs) that compared the sedative and clinical effectiveness of these two drugs in patients undergoing endoscopy were searched in a number of databases. The meta-analysis showed that dexmedetomidine demonstrated a significantly lower rate of respiratory depression and adverse events compared with those presented upon midazolam administration. A significant difference was also observed in the sedation potency of the sedatives. The current controlled data suggest that dexmedetomidine may be an alternative to midazolam in the sedation for endoscopy. However, more high-quality and well-designed studies are required to further evaluate this conclusion.
接受内镜检查的患者常常需要镇静,常用的药物包括咪达唑仑或右美托咪定。以往的荟萃分析主要集中在比较这两种药物在重症监护病房患者中的效果。在本研究中,我们在多个数据库中检索了比较这两种药物在接受内镜检查患者中的镇静效果和临床有效性的随机对照试验(RCT)。荟萃分析表明,与使用咪达唑仑相比,右美托咪定导致呼吸抑制和不良事件的发生率显著更低。在镇静药物的镇静效力方面也观察到了显著差异。目前的对照数据表明,右美托咪定可能是内镜检查镇静中咪达唑仑的替代药物。然而,需要更多高质量和设计良好的研究来进一步评估这一结论。