右美托咪定与咪达唑仑用于牙科手术的比较：一项系统评价与荟萃分析。
Comparison of dexmedetomidine with midazolam for dental surgery: A systematic review and meta-analysis.
作者信息
Zhang Yibo, Li Chao, Shi Jingjing, Gong Yanming, Zeng Tao, Lin Min, Zhang Xi
机构信息
Department of Anesthesiology.
Department of Orthopedics.
出版信息
Medicine (Baltimore). 2020 Oct 23;99(43):e22288. doi: 10.1097/MD.0000000000022288.
INTRODUCTION
Dexmedetomidine and midazolam have become important approaches for the sedation of dental surgery. However, the comparison of these 2 drugs for the sedation of dental surgery has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of dexmedetomidine versus midazolam for dental surgery.
METHODS
PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of dexmedetomidine versus midazolam on dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model.
RESULTS
Five RCTs and 420 patients are included in the meta-analysis. Compared with midazolam intervention for dental surgery, dexmedetomidine intervention has similar lowest SpO2, lowest heart rate and lowest systolic blood pressure, duration of surgery, and total volume of local anesthetic, but is associated with stable and reduced lowest diastolic blood pressure.
CONCLUSIONS
Similar benefits of dexmedetomidine and midazolam intervention are observed for the sedation of dental surgery in terms of SpO2, heart rate, systolic blood pressure, and the volume of local anesthetic, but dexmedetomidine may result in more stable diastolic blood pressure.
引言
右美托咪定和咪达唑仑已成为牙科手术镇静的重要方法。然而，这两种药物用于牙科手术镇静的比较尚未明确。我们进行了一项系统评价和荟萃分析，以评估右美托咪定与咪达唑仑用于牙科手术的疗效。
方法
检索了PubMed、Embase和Cochrane对照试验中央注册库。纳入评估右美托咪定与咪达唑仑对牙科手术影响的随机对照试验（RCT）。两名研究者独立检索文章、提取数据并评估纳入研究的质量。使用随机效应模型进行荟萃分析。
结果
荟萃分析纳入了5项RCT和420例患者。与咪达唑仑用于牙科手术的干预相比，右美托咪定干预具有相似的最低SpO2、最低心率和最低收缩压、手术持续时间以及局部麻醉剂总量，但与更低且稳定的最低舒张压相关。
结论
在SpO2、心率、收缩压和局部麻醉剂用量方面，右美托咪定和咪达唑仑干预用于牙科手术镇静的效果相似，但右美托咪定可能使舒张压更稳定。
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