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右美托咪定作为腹部手术局部浸润麻醉辅助剂的疗效:随机对照试验的荟萃分析。

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta-analysis of randomised controlled trials.

机构信息

Key Laboratory of Clinical Resources Translation, Henan University, Kaifeng, China.

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.

出版信息

Int Wound J. 2019 Oct;16(5):1206-1213. doi: 10.1111/iwj.13195. Epub 2019 Aug 16.

DOI:10.1111/iwj.13195
PMID:31418529
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7948599/
Abstract

To assess the efficacy and safety of dexmedetomidine (DEX) as an adjuvant to local wound infiltration anaesthesia in abdominal surgery, we conducted this meta-analysis. First, the systematic search strategy was performed on PubMed, Embase, and Cochrane Library and five randomised controlled trials (RCTs) involving 294 patients were included. Then, the outcome data were extracted from the studies and their effect sizes were calculated using Review Manager 5. As a result, the addition of DEX significantly reduced visual analogy scores at 6 hours after surgery (mean difference = -0.53[-0.82, -0.25], P < .001), 12 hours after surgery (mean difference = -0.39 [-0.73, -0.05]; P = .03), and 24 hours after surgery (mean difference = -0.20 [-0.29, -0.11], P < .001) and reduced total analgesic consumption within 24 hours after surgery (mean difference = -4.92 [-9.00, -0.84]; P = .02) compared with placebo groups. However, there was no difference in the incidence of postoperative nausea and vomiting (risk ratio = 0.68 [0.41, 1.14]; P = .14). In summary, DEX as a local anaesthetic adjuvant added for local wound infiltration anaesthesia in abdominal surgery could reduce visual analogy scores and postoperative analgesic consumption without changing incidence of postoperative nausea and vomiting.

摘要

为了评估右美托咪定(DEX)作为腹部手术局部浸润麻醉辅助剂的疗效和安全性,我们进行了这项荟萃分析。首先,我们在 PubMed、Embase 和 Cochrane Library 上进行了系统的搜索策略,共纳入了 5 项涉及 294 名患者的随机对照试验(RCT)。然后,我们从研究中提取了结局数据,并使用 Review Manager 5 计算了其效应量。结果表明,与安慰剂组相比,DEX 的添加显著降低了术后 6 小时(均数差=-0.53[-0.82,-0.25],P < .001)、12 小时(均数差=-0.39[-0.73,-0.05];P =.03)和 24 小时(均数差=-0.20[-0.29,-0.11],P < .001)的视觉模拟评分,并且降低了术后 24 小时内的总镇痛药物消耗量(均数差=-4.92[-9.00,-0.84];P =.02)。然而,DEX 组和安慰剂组术后恶心和呕吐的发生率没有差异(风险比=0.68[0.41,1.14];P =.14)。总之,DEX 作为局部麻醉辅助剂添加到腹部手术局部浸润麻醉中,可以降低视觉模拟评分和术后镇痛药物的消耗量,而不改变术后恶心和呕吐的发生率。

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