Shi Hongbin, Zhang Huaping, Pan Weizhong, Lu Youyi, Zhang Yong, Chen Linjing, Wei Chunxiao, Cui Yuanshan
Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, China.
Department of Gastrointestinal Surgery Ward II, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Low Urin Tract Symptoms. 2021 Jan;13(1):38-44. doi: 10.1111/luts.12322. Epub 2020 Jun 4.
The goal of the pooled analysis was to demonstrate the efficacy and safety of intraoperative dexmedetomidine in postoperative catheter-related bladder discomfort (CRBD).
MEDLINE, the Cochrane Central Register of Controlled Trials, and the Excerpta Medica Database (Embase) were used to pick out randomized controlled trials (RCTs) that used intraoperative dexmedetomidine in postoperative CRBD. This study was carried out using the preferred reporting items for systematic reviews and pooled analysis. We used RevMan version 5.3.0. to analyze the data.
Seven RCTs involving 607 patients were brought into in the analysis. The incidence of CRBD and the incidence of moderate to severe CRBD were assessed at 0 hours, 0.5 or 1 hour, 2 or 3 hours, 6 hours, and 12 or 24 hours postoperatively. The analysis proved that both the incidence of CRBD (P < .00001) and the incidence of moderate to severe CRBD had a statistically significant reduction at 0 hours, 0.5 or 1 hours, 2 or 3 hours, and 6 hours postoperatively (P < .00001, P <.00001, P <.00001, P = .003, respectively). The postoperative pain score was lower in the dexmedetomidine group at 0 hours (P < .00001) and 1 hour (P = .002). Safety assessments indicated that there were no statistical differences between dexmedetomidine and control for side effects, mainly including dry mouth (P = .99) and postoperative vomiting and nausea (P = .77).
The pooled analysis demonstrates that intraoperative dexmedetomidine administration decreases the rate and severity of early postoperative CRBD without causing significant side effects.
汇总分析的目的是证明术中使用右美托咪定对术后导管相关膀胱不适（CRBD）的有效性和安全性。
使用MEDLINE、Cochrane对照试验中央注册库和医学文摘数据库（Embase）筛选在术后CRBD中使用术中右美托咪定的随机对照试验（RCT）。本研究按照系统评价和汇总分析的首选报告项目进行。我们使用RevMan 5.3.0版分析数据。
7项涉及607例患者的RCT纳入分析。在术后0小时、0.5或1小时、2或3小时、6小时以及12或24小时评估CRBD的发生率和中重度CRBD的发生率。分析证明，术后0小时、0.5或1小时、2或3小时以及6小时，CRBD的发生率（P <.00001）和中重度CRBD的发生率均有统计学显著降低（分别为P <.00001、P <.00001、P <.00001、P =.003）。右美托咪定组术后0小时（P <.00001）和1小时（P =.002）的疼痛评分较低。安全性评估表明，右美托咪定组和对照组在副作用方面无统计学差异，主要副作用包括口干（P =.99）和术后呕吐及恶心（P =.77）。
汇总分析表明，术中给予右美托咪定可降低术后早期CRBD的发生率和严重程度，且不会引起明显副作用。
