右美托咪定对七氟醚全身麻醉下儿童的影响：荟萃分析和系统评价。

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review.

机构信息

Department of Anaesthesiology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Centre for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Paediatrics, Chongqing, China.

Department of Anaesthesiology, Chongqing Emergency Medical Centre, Chongqing, China.

出版信息

J Int Med Res. 2020 Jun;48(6):300060520927530. doi: 10.1177/0300060520927530.

OBJECTIVE

The sedative effects of dexmedetomidine (Dex) are similar to natural sleep, with easy wakening following Dex administration, and Dex has minor effects on breathing, reducing emergence agitation in children. The aim of this study was to systematically evaluate the effects of Dex on recovery quality in children following general anaesthesia with sevoflurane, to aid clinical decision making.

METHODS

Relevant randomized controlled trials published before August 2019 were searched and selected from databases. Two researchers independently screened the literature, extracted data, and assessed included studies for bias risk. Meta-analysis was performed using Stata 14.0 software.

RESULTS

The study included 24 publications. Following general anaesthesia by sevoflurane, Dex was associated with reduced occurrence of emergence agitation (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.11, 0.25) and nausea and vomiting (OR 0.40, 95% CI 0.24, 0.60), along with shortened eye-opening time (standardized mean difference [SMD] 0.72, 95% CI 0.41, 1.03), shortened extubation time (SMD 0.54, 95% CI 0.28, 0.81), and reduced duration of post-anaesthesia care unit (PACU) stay (SMD 0.29, 95% CI 0.08, 0.51) versus placebo.

CONCLUSION

Dexmedetomidine has positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane.

目的

右美托咪定（Dex）的镇静作用类似于自然睡眠，在给予 Dex 后易于唤醒，并且对呼吸的影响较小，可减少儿童苏醒期躁动。本研究旨在系统评价右美托咪定对七氟醚全身麻醉后儿童恢复质量的影响，为临床决策提供依据。

方法

检索并筛选了截至 2019 年 8 月前发表的相关随机对照试验数据库。两位研究者独立筛选文献、提取数据，并评估纳入研究的偏倚风险。采用 Stata 14.0 软件进行荟萃分析。

结果

本研究共纳入 24 篇文献。与七氟醚全身麻醉相比，右美托咪定可降低苏醒期躁动（比值比 [OR] 0.16，95%置信区间 [CI] 0.11，0.25）和恶心呕吐（OR 0.40，95% CI 0.24，0.60）的发生率，缩短睁眼时间（标准化均数差 [SMD] 0.72，95% CI 0.41，1.03）、拔管时间（SMD 0.54，95% CI 0.28，0.81）和麻醉后恢复室（PACU）停留时间（SMD 0.29，95% CI 0.08，0.51）。