Department of Anesthesiology, Huashan Hospital North Affiliated to Fudan University, Shanghai, PR China.
Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai, PR China.
Medicine (Baltimore). 2021 Dec 30;100(52):e28217. doi: 10.1097/MD.0000000000028217.
The effective therapy to reduce postoperative catheter-related bladder discomfort (CRBD) remained unknown.
We attempted to manage the systematic review and a meta-analysis to clarify the efficacy of dexmedetomidine (DEX) in potential prevention on CRBD.
We performed the meta-analysis on randomized clinical trials (RCTs), and searched the databases from Web of Sciences, Embase and referred Cochrane Library published from October 2016 to September 2020. Data extraction was carefully conducted by 2 authors, respectively. Meta-analysis that was applied synthetically concerns the incidence and severity of CRBD and the treatment effect of DEX on CRBD.
We acquired 5 RCTs with interventions of DEX on CRBD. Meta-analysis showed DEX has significantly reduced the incidence and severity of CRBD compared with control at 0 hour (risk ratios [RR] = 0.40, 95% CI = 0.53-0.29, P < .01), 1 hour (RR = 0.44, 95% CI = 0.34-0.57, P < .01), and 2 hours (RR = 0.43, 95% CI = 0.32-0.58, P < .01) and 6 hours (RR = 0.43, 95% CI = 0.29-0.63, P < .01). DEX was also associated with lower incidence of moderate to severe CRBD at 0, 1, and 6 hours after surgery. There were no significant differences in adverse events other than bradycardia, hypotension, and hypertension.
The 5 RCTs showed great effectiveness in reducing the incidence and severity of the early and later postoperative CRBD. Meta-analysis showed that DEX interventions were useful in preventing the early and later postoperative CRBD without significant side effects.
减轻术后导尿管相关性膀胱不适（CRBD）的有效治疗方法仍不清楚。
我们试图对系统评价和荟萃分析进行管理，以明确右美托咪定（DEX）在潜在预防 CRBD 方面的疗效。
我们对随机对照试验（RCT）进行了荟萃分析，并从 Web of Sciences、Embase 和 Cochrane Library 中检索了 2016 年 10 月至 2020 年 9 月发表的数据库。两位作者分别仔细进行了数据提取。荟萃分析综合考虑了 CRBD 的发生率和严重程度以及 DEX 对 CRBD 的治疗效果。
我们获得了 5 项关于 DEX 干预 CRBD 的 RCT。荟萃分析显示，与对照组相比，DEX 在 0 小时（风险比[RR]＝0.40，95％CI＝0.53-0.29，P<.01）、1 小时（RR＝0.44，95％CI＝0.34-0.57，P<.01）、2 小时（RR＝0.43，95％CI＝0.32-0.58，P<.01）和 6 小时（RR＝0.43，95％CI＝0.29-0.63，P<.01）时的 CRBD 发生率和严重程度显著降低。DEX 还与术后 0、1 和 6 小时时中度至重度 CRBD 的发生率降低相关。除心动过缓、低血压和高血压外，其他不良反应无显著差异。
这 5 项 RCT 表明，DEX 干预在降低早期和晚期术后 CRBD 的发生率和严重程度方面具有显著效果。荟萃分析表明，DEX 干预在预防早期和晚期术后 CRBD 方面有效，且无明显副作用。
