Du Xueke, Zhou Chengmao, Pan Linghui, Li Changlong
Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
Department of Surgery, Zhaoqing Medical College, Zhaoqing Shi, Guangdong Sheng, People's Republic of China.
Drug Des Devel Ther. 2017 Feb 8;11:365-370. doi: 10.2147/DDDT.S121979. eCollection 2017.
To investigate the effect of dexmedetomidine in the prevention of etomidate-induced myoclonus.
We searched for randomized controlled trials (RCTs) regarding the use of dexmedetomidine in preventing etomidate-induced myoclonus in the databases PubMed, EMBASE, the Cochrane Library, and CNKI. We extracted data and assessed the quality of the literature and adopted RevMan 5.2 to conduct meta-analysis on each effective index and employed funnel plot to test publication bias.
The results showed that the incidence of etomidate-induced myoclonus in the dexmedetomidine treated groups was significantly lower than that of the control groups (risk ratio [RR]=0.27, 95% confidence interval [CI] [0.15, 0.47], <0.00001). With regard to the severity of etomidate-induced myoclonus, incidences of etomidate-induced myoclonus in the dexmedetomidine treated groups resulting in mild myoclonus (RR=0.37, 95% CI [0.19, 0.75], =0.006), moderate myoclonus (RR=0.21, 95% CI [0.12, 0.37], <0.00001), or severe myoclonus (RR=0.18, 95% CI [0.08, 0.38], <0.00001) were significantly lower than those of the control groups. No statistically significant difference was found (RR=0.70, 95% CI [0.47, 1.04], =0.08) between etomidate-induced myoclonus in the dexmedetomidine treated groups and that of the midazolam treated groups.
Dexmedetomidine can effectively prevent the incidence of etomidate-induced myoclonus and reduce the severity of etomidate-induced myoclonus. In addition, there were no significant differences between the effects of dexmedetomidine and midazolam in preventing etomidate-induced myoclonus.
探讨右美托咪定预防依托咪酯诱发肌阵挛的效果。
在PubMed、EMBASE、Cochrane图书馆及CNKI数据库中检索关于右美托咪定预防依托咪酯诱发肌阵挛的随机对照试验（RCT）。提取数据并评估文献质量，采用RevMan 5.2对各有效指标进行Meta分析，采用漏斗图检验发表偏倚。
结果显示，右美托咪定治疗组依托咪酯诱发肌阵挛的发生率显著低于对照组（风险比[RR]=0.27，95%置信区间[CI][0.15，0.47]，<0.00001）。关于依托咪酯诱发肌阵挛的严重程度，右美托咪定治疗组中导致轻度肌阵挛（RR=0.37，95%CI[0.19，0.75]，=0.006）、中度肌阵挛（RR=0.21，95%CI[0.12，0.37]，<0.00001）或重度肌阵挛（RR=0.18，95%CI[0.08，0.38]，<0.00001）的依托咪酯诱发肌阵挛的发生率均显著低于对照组。右美托咪定治疗组与咪达唑仑治疗组的依托咪酯诱发肌阵挛之间未发现统计学显著差异（RR=0.70，95%CI[0.47，1.04]，=0.08）。
右美托咪定可有效预防依托咪酯诱发肌阵挛的发生率，并降低依托咪酯诱发肌阵挛的严重程度。此外，右美托咪定与咪达唑仑在预防依托咪酯诱发肌阵挛的效果上无显著差异。
