Ke Yanjun, Gao Liqing, Xia Dongyun, Liu Zhonggui
Department of Anesthesiology, Shaoxing Maternity and Child Health Care Hospital Shaoxing 312000, Zhejiang, China.
Am J Transl Res. 2024 Nov 15;16(11):6225-6235. doi: 10.62347/XRDG3903. eCollection 2024.
To evaluate the anesthetic effects of sufentanil and fentanyl in pediatric surgery.
We conducted a comprehensive search across multiple databases, including Wanfang, CNKI, Chinese Biomedical Literature, VIP, Embase, PubMed, Cochrane Library, and Web of Science. Studies were retrieved to screen randomized controlled trials (RCTs) comparing sufentanil and fentanyl use in children during surgery. Primary outcomes included mean arterial pressure (MAP), heart rate (HR), Ramsay sedation score, and restlessness score (RS). Pooled and sensitivity analyses were performed, and risk of bias was assessed.
Fourteen studies compared the efficacy of sufentanil and fentanyl in terms of MAP immediately after intubation. The results demonstrated that sufentanil exhibited a more pronounced reduction in MAP compared with fentanyl (SMD: -0.62; 95% CI = [-0.97, -0.27]; I = 79.6%, P < 0.001). A total of 5 studies compared the efficacy of sufentanil and fentanyl in MAP at five and fifteen minutes after intubation, with sufentanil again showing a more pronounced reduction in MAP compared with fentanyl (P < 0.05). Additionally, sufentanil resulted in a more stable HR compared to fentanyl (SMD: -0.46; 95% CI = -0.58 - -0.33; I = 53.5%, P < 0.0001). There were 4 studies reporting the effects of sufentanil on RS, indicating that sufentanil led to significantly greater reductions in RS compared to fentanyl (SMD: -1.59; 95% CI = [-2.52, -0.66]; I = 91.5%, P < 0.001).
Among the children undergoing surgery, sufentanil demonstrates more advantages over fentanyl in maintaining stable hemodynamics and reducing postoperative agitation, offering better clinical benefits.
评估舒芬太尼和芬太尼在小儿外科手术中的麻醉效果。
我们对多个数据库进行了全面检索，包括万方、知网、中国生物医学文献数据库、维普、Embase、PubMed、Cochrane图书馆和Web of Science。检索研究以筛选比较舒芬太尼和芬太尼在儿童手术中使用情况的随机对照试验（RCT）。主要结局包括平均动脉压（MAP）、心率（HR）、Ramsay镇静评分和躁动评分（RS）。进行了合并分析和敏感性分析，并评估了偏倚风险。
14项研究比较了舒芬太尼和芬太尼在插管后即刻对MAP的影响。结果表明，与芬太尼相比，舒芬太尼使MAP降低更为显著（标准化均数差：-0.62；95%置信区间=[-0.97, -0.27]；I² = 79.6%，P < 0.001）。共有5项研究比较了舒芬太尼和芬太尼在插管后5分钟和15分钟时对MAP的影响，舒芬太尼再次显示出比芬太尼更显著地降低MAP（P < 0.05）。此外，与芬太尼相比，舒芬太尼使HR更稳定（标准化均数差：-0.46；95%置信区间=-0.58 - -0.33；I² = 53.5%；P < 0.0001）。有4项研究报告了舒芬太尼对RS的影响，表明与芬太尼相比，舒芬太尼使RS显著降低更多（标准化均数差：-1.59；95%置信区间=[-2.52, -0.66]；I² = 91.5%；P < 0.001）。
在接受手术的儿童中，舒芬太尼在维持稳定血流动力学和减少术后躁动方面比芬太尼更具优势，具有更好的临床效益。
