侵入性针刺对全身麻醉后苏醒质量的影响：系统评价与荟萃分析
Effect of invasive acupuncture on awakening quality after general anesthesia: systematic review and meta-analysis.
作者信息
Bu Fan-Dong, Si Shang-Kun, Zhang Dong-Bin, Chi Yong-Liang
机构信息
The First Clinical College of Shandong University of Traditional Chinese Medicine, Jinan, China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
出版信息
Front Med (Lausanne). 2025 Jan 13;11:1502619. doi: 10.3389/fmed.2024.1502619. eCollection 2024.
BACKGROUND
The process of waking up from general anesthesia is still not well understood, and recovery issues such as delayed awakening, agitation, postoperative cognitive dysfunction, continue to be a challenge for anesthesiologists. Currently, the treatment of these complications is mainly achieved through the antagonistic action of specific drugs, but sometimes the antagonistic drugs are not as effective as they should be and can add to the financial burden of the patient. Acupuncture, a common treatment in Traditional Chinese Medicine, is widely used around surgery. However, there is no enough evidence to show it improves recovery after anesthesia. To explore this, we reviewed relevant randomized trials and conducted a meta-analysis.
OBJECTIVE
This systematic review was conducted to explore the effect of perioperative application of invasive acupuncture on the quality of postoperative awakening after general anesthesia.
METHODS
By searching PubMed, Embase, Cochrane Clinical Trials Center, China Knowledge Network (CNKI), China Biomedical Database (CBM), Wanfang Medical Database, Weipu Database, to include randomized controlled trials of invasive acupuncture applied perioperatively. Search is limited from the build-up of the database to March 2022. The statistical analysis was conducted using RevMan 5.3. Quality assessment of the included research literature using Cochrane-recommended risk of bias assessment tool.
RESULTS
18 randomized controlled trials were included with 1,127 patients. 565 patients in invasive acupuncture intervention group, 562 patients in control group. Results showed that invasive acupuncture group had a shorter eye opening time than control group (MD = -6.42, 95% CI [-8.17, -4.66], < 0.001), shorter extubation times (MD = -5.84, 95% CI [-8.12, -3.56], < 0.001), lower MAP at extubation (MD = -18.54, 95% CI [-22.69, -14.39], < 0.001), lower HR at extubation (MD = -14.85, 95% CI [-23.90, -5.81], < 0.001). No statistical difference in the occurrence of POCD (OR = 0.56, 95% CI [0.28, 1.11], = 0.10) and postoperative agitation (OR = 0.42, 95% CI [0.11, 1.65], = 0.21).
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, CRD42023410260.
背景
全身麻醉苏醒过程仍未被完全理解，诸如苏醒延迟、躁动、术后认知功能障碍等恢复问题，仍然是麻醉医生面临的挑战。目前，这些并发症的治疗主要通过特定药物的拮抗作用来实现，但有时拮抗药物的效果并不理想，还会增加患者的经济负担。针灸作为中医的一种常见疗法，在手术前后被广泛应用。然而，尚无足够证据表明其能改善麻醉后的恢复情况。为探究这一问题，我们回顾了相关随机试验并进行了荟萃分析。
目的
本系统评价旨在探讨围手术期应用侵入性针灸对全身麻醉术后苏醒质量的影响。
方法
通过检索PubMed、Embase、Cochrane临床试验中心、中国知网（CNKI）、中国生物医学数据库（CBM）、万方医学数据库、维普数据库，纳入围手术期应用侵入性针灸的随机对照试验。检索时间范围为各数据库建库至2022年3月。使用RevMan 5.3进行统计分析。采用Cochrane推荐的偏倚风险评估工具对纳入的研究文献进行质量评估。
结果
纳入18项随机对照试验，共1127例患者。侵入性针灸干预组565例患者，对照组562例患者。结果显示，侵入性针灸组的睁眼时间短于对照组（MD = -6.42，95%CI [-8.17, -4.66]，P < 0.001），拔管时间短（MD = -5.84，95%CI [-8.12, -3.56]，P < 0.001），拔管时平均动脉压较低（MD = -18.54，95%CI [-22.69, -14.39]，P < 0.001），拔管时心率较低（MD = -14.85，95%CI [-23.90, -5.81]，P < 0.001）。术后认知功能障碍（OR = 0.56，95%CI [0.28, 1.11]，P = 0.10）和术后躁动（OR = 0.42，95%CI [0.11, 1.65]，P = 0.21）的发生率无统计学差异。
系统评价注册
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