鞘内注射哌替啶对剖宫产术后脊麻后寒战的影响：一项系统评价和荟萃分析。

The effect of intrathecal pethidine on post-spinal anesthesia shivering after cesarean section: a systematic review and meta-analysis.

作者信息

Afzal Muhammad, Lee Amber, Asad Muhammad, Ali Alya, Farrukh Ameer Mustafa, Semakieh Bader, Levin-Carrion Yaxel, Shah Shah Rukh, Khan Qaisar Ali

机构信息

St. George's University School of Medicine, True Blue, Grenada.

Arkansas College of Osteopathic Medicine, Fort Smith, AR.

出版信息

Ann Med Surg (Lond). 2024 Jul 22;86(9):5461-5470. doi: 10.1097/MS9.0000000000002354. eCollection 2024 Sep.

BACKGROUND

Spinal anesthesia is the most preferred method for cesarean section (C-section). This meta-analysis was performed to determine the effect of low and high intrathecal doses of pethidine on the maternal outcomes after C-section.

METHODS

A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was performed. Random-effects meta-analysis was performed to derive odds ratios (ORs) from dichotomous data.

RESULTS

Seventeen randomized controlled trials with 1304 C-section patients were included. Patients who had received intrathecal pethidine experienced decreased shivering and intensity of shivering (OR 0.13; <0.001) and (OR 0.21; <0.001), respectively. Moreover, vomiting (OR 2.47; =0.002) and pruritus (OR 5.92; <0.001) were significantly higher in the pethidine group. There was no statistically significant difference in the incidence of nausea (OR 2.55; =0.06) and hypotension (OR 0.91; =0.67).

CONCLUSIONS

Intrathecal pethidine can effectively decrease shivering, although it increases the risk of vomiting and pruritus. No significant difference was found both in the maternal hypotension and nausea.

背景

脊髓麻醉是剖宫产最常用的方法。本荟萃分析旨在确定鞘内注射低剂量和高剂量哌替啶对剖宫产后产妇结局的影响。

方法

对PubMed、Scopus、Cochrane图书馆和谷歌学术进行系统检索。采用随机效应荟萃分析从二分数据中得出比值比（OR）。

结果

纳入17项随机对照试验，共1304例剖宫产患者。接受鞘内注射哌替啶的患者寒战及寒战强度分别降低（OR 0.13；<0.001）和（OR 0.21；<0.001）。此外，哌替啶组呕吐（OR 2.47；=0.002）和瘙痒（OR 5.92；<0.001）明显更高。恶心（OR 2.55；=0.06）和低血压（OR 0.91；=0.67）的发生率无统计学显著差异。