Mohsin Saniya, Ahmad Ganaie Zubair, Kundi Hayan, Ahmed Muhammad Bilal, Riaz Bushra, Khurshid Ahmed Noman, Anirudh Chunchu Venkata, Haq Areeba
Baqai Medical College, Baqai Medical University, Karachi, PAK.
Internal Medicine, Holy Family Red Crescent Medical College, Srinagar, IND.
Cureus. 2022 Jun 22;14(6):e26194. doi: 10.7759/cureus.26194. eCollection 2022 Jun.
General anesthesia induction, tracheal intubation, extubation, and laryngoscopy are associated with specific hemodynamic changes. Tracheal intubation and laryngoscopy are related to sympathetic stimulation and lead to hypertension and tachycardia. Recent studies have shown that dexmedetomidine is safe and effective as it does not depress respiratory function. This meta-analysis aims to compare the efficacy of dexmedetomidine and fentanyl in preventing an increase in heart rate (HR) during intubation among patients undergoing general anesthesia. A systematic literature search was done using PubMed, Cochrane Library, and Embase to assess studies comparing the efficacy of dexmedetomidine and fentanyl in preventing an increase in HR during intubation. A meta-analysis was done utilizing a random-effects model, and mean differences of HR were determined between fentanyl and dexmedetomidine at baseline, one minute, five minutes, and 10 minutes of intubation. In this meta-analysis, eight randomized control trials were included, involving 548 patients (274 in the fentanyl group and 274 in the dexmedetomidine group). The findings showed that significant difference of HR was significantly lower in the dexmedetomidine group than the fentanyl group at one minute of intubation (mean difference = -8.46; P-value = 0.003), at five minutes of intubation (mean difference = -7.51; P-value = 0.001), and at 10 minutes of intubation (mean difference = -5.15; P-value = 0.030). In the current meta-analysis, dexmedetomidine was better than fentanyl in preventing tachycardia following endotracheal intubation. HR was significantly lower at one minute, five minutes, and 10 minutes after intubation in the dexmedetomidine group compared to the fentanyl group.
全身麻醉诱导、气管插管、拔管及喉镜检查均伴有特定的血流动力学变化。气管插管和喉镜检查与交感神经刺激有关，可导致高血压和心动过速。近期研究表明，右美托咪定安全有效，因为它不会抑制呼吸功能。本荟萃分析旨在比较右美托咪定和芬太尼在全身麻醉患者插管期间预防心率（HR）增加的疗效。通过使用PubMed、Cochrane图书馆和Embase进行系统的文献检索，以评估比较右美托咪定和芬太尼在预防插管期间HR增加疗效的研究。采用随机效应模型进行荟萃分析，并确定芬太尼和右美托咪定在插管基线、1分钟、5分钟和10分钟时HR的平均差异。在本荟萃分析中，纳入了8项随机对照试验，涉及548例患者（芬太尼组274例，右美托咪定组274例）。结果显示，在插管1分钟时（平均差异=-8.46；P值=0.003）、5分钟时（平均差异=-7.51；P值=0.001）和10分钟时（平均差异=-5.15；P值=0.030），右美托咪定组的HR显著低于芬太尼组。在当前的荟萃分析中，右美托咪定在预防气管插管后心动过速方面优于芬太尼。与芬太尼组相比，右美托咪定组在插管后1分钟、5分钟和10分钟时的HR显著更低。
