右美托咪定辅助胸腔镜手术的效果：一项随机对照试验的荟萃分析。

Effect of dexmedetomidine supplementation for thoracoscopic surgery: a meta-analysis of randomized controlled trials.

机构信息

Department of Cardiothoracic Surgery, Fenghua District People's Hospital of Ningbo, Zhejiang, China.

Department of Anesthesiology, Fenghua District People's Hospital of Ningbo, Zhejiang, China.

出版信息

J Cardiothorac Surg. 2022 Apr 6;17(1):70. doi: 10.1186/s13019-022-01803-z.

INTRODUCTION

The efficacy of dexmedetomidine supplementation for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of dexmedetomidine for thoracoscopic surgery.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine supplementation on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.

RESULTS

Six RCTs involving 510 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, dexmedetomidine supplementation results in significantly reduced pain scores (SMD = - 1.50; 95% CI = - 2.63-- 0.37; P = 0.009), anesthetic consumption (SMD = - 3.91; 95% CI = - 6.76-- 1.05; P = 0.007), mean heart rate (SMD = - 0.41; 95% CI = - 0.65-- 0.18; P = 0.0007), and the risk ratio (RR) of ICU stay (RR = 0.39; 95% CI = 0.19-0.80; P = 0.01), but showed no obvious effect on mean blood pressure (SMD = - 0.07; 95% CI = - 0.45-0.31; P = 0.72) or hospital stay (SMD = - 0.61; 95% CI = - 1.30-0.08; P = 0.08).

CONCLUSIONS

Dexmedetomidine supplementation can substantially improve the analgesic efficacy for thoracoscopic surgery.

简介

右美托咪定在胸腔镜手术中的疗效仍存在争议。我们进行了一项系统评价和荟萃分析，以探讨右美托咪定在胸腔镜手术中的作用。

方法

我们通过检索 PubMed、EMbase、Web of science、EBSCO 和 Cochrane 图书馆数据库，收集了截至 2020 年 9 月评估右美托咪定在胸腔镜手术中补充作用的随机对照试验（RCT）。该荟萃分析采用随机效应模型进行。

结果

纳入了 6 项 RCT，共 510 例患者。与胸腔镜手术对照组相比，整体上，右美托咪定补充治疗可显著降低疼痛评分（SMD=-1.50；95%CI=-2.63--0.37；P=0.009）、麻醉药物消耗（SMD=-3.91；95%CI=-6.76--1.05；P=0.007）、平均心率（SMD=-0.41；95%CI=-0.65--0.18；P=0.0007）和 ICU 入住率（RR=0.39；95%CI=0.19-0.80；P=0.01），但对平均血压（SMD=-0.07；95%CI=-0.45-0.31；P=0.72）或住院时间（SMD=-0.61；95%CI=-1.30-0.08；P=0.08）无明显影响。