Wang Zhizhen, Hu Zhi, Dai Tianyang
Department of Thoracic Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan, P.R. China.
Medicine (Baltimore). 2018 Sep;97(36):e12229. doi: 10.1097/MD.0000000000012229.
Propofol and midazolam are widely used for the sedation of bronchoscopy. This systematic review and meta-analysis is conducted to compare the efficacy of propofol and midazolam for bronchoscopy.
The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched for collecting the randomized controlled trials (RCTs) regarding the efficacy of propofol and midazolam for bronchoscopy.
This meta-analysis has included 4 RCTs. Compared with midazolam intervention in patients undergoing bronchoscopy, propofol intervention is associated with remarkably reduced recovery time [standard mean difference (SMD) = -0.74; 95% confidence interval (95% CI) = -1.04 to -0.45; P < .00001], but demonstrates no significant impact on operation time (SMD = -0.01; 95% CI = -0.16 to 0.13; P = .87), induction time (SMD = -0.58; 95% CI = -1.19 to 0.03; P = .06), lowest oxyhemoglobin saturation (SpO2, SMD = 0.24; 95% CI = -0.09 to 0.58; P = .15), SpO2 <90% [risk ratio (RR) = 1.02; 95% CI = 0.82-1.25; P = .88), and major arrhythmias (RR = 0.56; 95% CI = 0.26-1.19; P = .13).
Propofol sedation is able to reduce recovery time and shows similar safety compared with midazolam sedation during bronchoscopy.
丙泊酚和咪达唑仑广泛用于支气管镜检查的镇静。本系统评价和荟萃分析旨在比较丙泊酚和咪达唑仑用于支气管镜检查的疗效。
系统检索包括PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库在内的数据库,以收集关于丙泊酚和咪达唑仑用于支气管镜检查疗效的随机对照试验(RCT)。
该荟萃分析纳入了4项RCT。与接受支气管镜检查患者的咪达唑仑干预相比,丙泊酚干预可显著缩短恢复时间[标准均数差(SMD)=-0.74;95%置信区间(95%CI)=-1.04至-0.45;P<0.00001],但对手术时间(SMD=-0.01;95%CI=-0.16至0.13;P=0.87)、诱导时间(SMD=-0.58;95%CI=-1.19至0.03;P=0.06)、最低氧合血红蛋白饱和度(SpO2,SMD=0.24;95%CI=-0.09至0.58;P=0.15)、SpO2<90%[风险比(RR)=1.02;95%CI=0.82-1.25;P=0.88]和主要心律失常(RR=0.56;95%CI=0.26-1.19;P=0.13)无显著影响。
在支气管镜检查期间,丙泊酚镇静能够缩短恢复时间,且与咪达唑仑镇静具有相似的安全性。