右美托咪定在经蝶窦垂体瘤切除术中的应用：一项随机对照试验的荟萃分析。

Supplementation With Dexmedetomidine for Transsphenoidal Resection of Pituitary Adenoma: A Meta-Analysis of Randomized Controlled Trials.

机构信息

Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan.

Department of Neurosurgery, People's Hospital of Tongxin County, Wuzhong, Ningxia.

出版信息

Clin Neuropharmacol. 2021;44(1):17-20. doi: 10.1097/WNF.0000000000000426.

DOI:10.1097/WNF.0000000000000426

PMID:33449475

Abstract

INTRODUCTION

The effect of dexmedetomidine supplementation on hemodynamic stability for transsphenoidal resection of pituitary adenoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexmedetomidine supplementation on hemodynamic stability for transsphenoidal resection of pituitary adenoma.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2020 for randomized controlled trials assessing the effect of dexmedetomidine supplementation on transsphenoidal resection of pituitary adenoma.

RESULTS

Four randomized controlled trials involving 160 patients were included in the meta-analysis. Overall, compared with the control group for transsphenoidal resection of pituitary adenoma, dexmedetomidine supplementation resulted in significantly reduced mean arterial pressure at 30 minutes [mean difference (MD), -26.62; 95% confidence interval (CI), -36.71 to -16.53; P < 0.00001], heart rate at 30 minutes (MD, -16.50; 95% CI, -32.48 to -0.53; P = 0.04), blood loss (MD, -112.57; 95% CI, -165.12 to -60.01; P < 0.0001), and fentanyl (MD, -154.13; 95% CI, -303.97 to -4.29; P = 0.04), but demonstrated similar incidence of nausea and vomiting (odds ratio, 0.37; 95% CI, 0.13-1.03; P = 0.06), and hypotension (odds ratio, 2.11; 95% CI, 0.49-9.22; P = 0.32).

CONCLUSIONS

Dexmedetomidine supplementation was effective in improving hemodynamic stability for transsphenoidal resection of pituitary adenoma.

摘要

简介

右美托咪定在经蝶窦垂体瘤切除术患者中的应用对血流动力学稳定性的影响仍存在争议。我们进行了一项系统回顾和荟萃分析，以探讨右美托咪定在经蝶窦垂体瘤切除术患者中的应用对血流动力学稳定性的影响。

方法

我们通过 2020 年 8 月之前在 PubMed、EMbase、Web of Science、EBSCO 和 Cochrane 图书馆数据库中搜索了评估右美托咪定在经蝶窦垂体瘤切除术患者中的应用效果的随机对照试验。

结果

纳入了 4 项随机对照试验，共 160 例患者纳入荟萃分析。与经蝶窦垂体瘤切除术患者的对照组相比，右美托咪定的应用显著降低了 30 分钟时的平均动脉压[平均差（MD），-26.62；95%置信区间（CI），-36.71 至-16.53；P<0.00001]、30 分钟时的心率（MD，-16.50；95%CI，-32.48 至-0.53；P=0.04）、出血量（MD，-112.57；95%CI，-165.12 至-60.01；P<0.0001）和芬太尼（MD，-154.13；95%CI，-303.97 至-4.29；P=0.04），但恶心和呕吐的发生率相似（比值比，0.37；95%CI，0.13-1.03；P=0.06），低血压的发生率相似（比值比，2.11；95%CI，0.49-9.22；P=0.32）。