挥发性麻醉剂选择对心脏手术后术后结果的影响：荟萃分析。
The Impact of Volatile Anesthetic Choice on Postoperative Outcomes of Cardiac Surgery: A Meta-Analysis.
机构信息
Faculty of Health, Universidad del Valle, School of Medicine, Hospital Universitario del Valle, Cali, Colombia.
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA.
出版信息
Biomed Res Int. 2017;2017:7073401. doi: 10.1155/2017/7073401. Epub 2017 Aug 29.
OBJECTIVES
To evaluate the impact of volatile anesthetic choice on clinically relevant outcomes of patients undergoing cardiac surgery.
METHODS
Major databases were systematically searched for randomized controlled trials (RCTs) comparing volatile anesthetics (isoflurane versus sevoflurane) in cardiac surgery. Study-level characteristics, intraoperative events, and postoperative outcomes were extracted from the articles.
RESULTS
Sixteen RCTs involving 961 patients were included in this meta-analysis. There were no significant differences between both anesthetics in terms of intensive care unit length of stay (SMD -0.07, 95% CI -0.38 to 0.24, = 0.66), hospital length of stay (SMD 0.06, 95% CI -0.33 to 0.45, = 0.76), time to extubation (SMD 0.29, 95% CI -0.08 to 0.65, = 0.12), S100 (at the end of surgery: SMD 0.08, 95% CI -0.33 to 0.49, = 0.71; 24 hours after surgery: SMD 0.21, 95% CI -0.23 to 0.65, = 0.34), or troponin (at the end of surgery: SMD -1.13, 95% CI -2.39 to 0.13, = 0.08; 24 hours after surgery: SMD 0.74, 95% CI -0.15 to 1.62, = 0.10). CK-MB was shown to be significantly increased when using isoflurane instead of sevoflurane (SMD 2.16, 95% CI 0.57 to 3.74, = 0.008).
CONCLUSIONS
The volatile anesthetic choice has no significant impact on postoperative outcomes of patients undergoing cardiac surgery.
目的
评估心脏手术中使用挥发性麻醉剂对临床相关结局的影响。
方法
系统检索主要数据库中比较心脏手术中使用挥发性麻醉剂（异氟醚与七氟醚）的随机对照试验（RCT）。从文章中提取研究水平特征、术中事件和术后结局。
结果
这项荟萃分析纳入了 16 项 RCT 共 961 例患者。两种麻醉剂在重症监护病房停留时间（SMD -0.07，95%CI -0.38 至 0.24， = 0.66）、住院时间（SMD 0.06，95%CI -0.33 至 0.45， = 0.76）、拔管时间（SMD 0.29，95%CI -0.08 至 0.65， = 0.12）、S100（手术结束时：SMD 0.08，95%CI -0.33 至 0.49， = 0.71；手术后 24 小时：SMD 0.21，95%CI -0.23 至 0.65， = 0.34）或肌钙蛋白（手术结束时：SMD -1.13，95%CI -2.39 至 0.13， = 0.08；手术后 24 小时：SMD 0.74，95%CI -0.15 至 1.62， = 0.10）方面无显著差异。与使用七氟醚相比，使用异氟醚时 CK-MB 显著升高（SMD 2.16，95%CI 0.57 至 3.74， = 0.008）。
结论
挥发性麻醉剂的选择对心脏手术患者的术后结局无显著影响。
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