Zhou Qiang, Shen Lingli, Zhang Xinxian, Li Jiong, Tang Yong
Department of Radiology, XuZhou Children's Hospital, Xuzhou, Jiangsu 221006, China.
Department of Neurology, The Tenth Ward, XuZhou Children's Hospital, Xuzhou, Jiangsu 221006, China.
Oncotarget. 2017 Nov 1;8(60):102468-102473. doi: 10.18632/oncotarget.22271. eCollection 2017 Nov 24.
Magnetic resonance imaging (MRI) is a widely applied diagnostic approach for detection of pediatric diseases. Sedatives are commonly used to acquire the accurate MRI images. Dexmedetomidine and propofol serve as sole or combined sedatives in pediatric MRI scanning. This meta-analysis aimed to compare the efficacy of dexmedetomidine and propofol in children ubdergoing MRI. Pubmed, Cochrane Library and Web of Science were searched up to June, 2017. Onset of sedation time, recovery time, sedation time, MRI time, MRI quality and emergence delirium were analyzed. 6 studies with 368 subjects were enrolled in this meta-analysis. The pooling data showed that propofol had a shorter onset of sedation time (WMD: 6.05, 95% CI: 3.12 - 8.98, < 0.0001) and recovery time (WMD: 1.01, 95% CI: 0.36-1.67, < 0.001) than dexmedetomidine. But for sedation time and MRI scanning time, there were no differences between the two groups (sedation time: = 0.29; MRI scanning time: = 0.50). There were no significance between dexmedetomidine and propofol on MRI quality (MRI quality 1: = 1.00; MRI quality 2: = 0.68; MRI quality 3: = 0.45). Two studies using Pediatric Anesthesia Emergence Delirium (PAED) to assess emergence delirium 10 minutes after awakening showed that propofol had a lower PAED than dexmedetomidine (WMD: 2.57, 95% CI: 0.15-5.00, = 0.04). Thus, propofol should be encouraged in pediatric patients undergoing MRI for its better sedative effects and a low incidence of emergence delirium.
磁共振成像（MRI）是一种广泛应用于儿科疾病检测的诊断方法。镇静剂常用于获取准确的MRI图像。右美托咪定和丙泊酚在儿科MRI扫描中分别或联合用作镇静剂。这项荟萃分析旨在比较右美托咪定和丙泊酚在接受MRI检查的儿童中的疗效。检索了截至2017年6月的PubMed、Cochrane图书馆和科学网。分析了镇静起效时间、恢复时间、镇静时间、MRI检查时间、MRI图像质量和苏醒期谵妄情况。本荟萃分析纳入了6项研究，共368名受试者。汇总数据显示，丙泊酚的镇静起效时间（加权均数差：6.05，95%可信区间：3.12 - 8.98，P<0.0001）和恢复时间（加权均数差：1.01，95%可信区间：0.36 - 1.67，P<0.001）比右美托咪定短。但在镇静时间和MRI扫描时间方面，两组之间没有差异（镇静时间：P = 0.29；MRI扫描时间：P = 0.50）。右美托咪定和丙泊酚在MRI图像质量方面没有显著差异（MRI图像质量1：P = 1.00；MRI图像质量2：P = 0.68；MRI图像质量3：P = 0.45）。两项使用小儿麻醉苏醒期谵妄（PAED）量表评估苏醒10分钟后谵妄情况的研究表明，丙泊酚的PAED评分低于右美托咪定（加权均数差：2.57，95%可信区间：0.15 - 5.00，P = 0.04）。因此，对于接受MRI检查的儿科患者，应鼓励使用丙泊酚，因为其镇静效果更好，苏醒期谵妄发生率较低。
