摘要
目的:基于循证药学手段,评价鞘内注射右美托咪定对剖宫产术腰麻期间不良反应的预防效果。方法:计算机检索PubMed,EMBASE,The Cochrane Library和中国知网,收集鞘内注射右美托咪定对剖宫产术腰麻期间不良反应预防效果的临床随机对照试验。从纳入的研究中提取资料并对其进行质量评价,再用RevMan 5.3软件进行Meta分析。结果:最终纳入4项随机对照试验,共278例患者。Meta分析结果显示:右美托咪定组寒战发生率显著低于对照组[RR=0.40,95%CI(0.25~0.65),P=0.0002];而右美托咪定组的恶心呕吐[RR=1.08,95%CI(0.68~1.71),P=0.74]、心动过缓[RR=1.33,95%CI(0.31~5.76),P=0.70]和低血压[RR=0.78,95%CI(0.59~1.03),P=0.08]发生率与对照组相当,差异无统计学意义。结论:鞘内注射右美托咪定可显著降低剖宫产术腰麻期间的寒战发生率,但对恶心呕吐、心动过缓和低血压等不良反应无影响。
Objective:To evaluate the preventive effect of intrathecal dexmedetomidine in cesarean section during spinal anesthesia based on evidence-based pharmacy.Methods:Randomized controlled trials regarding the preventive effect of intrathecal dexmedetomidine in cesarean section during spinal anesthesia were searched in the databases PubMed,EMBASE,The Cochrane Library and CNKI.We extracted data and assessed the quality of the literature and adopted RevMan 5.3 to conduct meta-analysis on each effective index.Results:A total of 278 patients from 4 studies were included in this meta-analysis.The incidence of shivering in the dexmedetomidine groups was significantly lower than that in the placebo groups during cesarean section[RR=0.40,95%CI(0.25~0.65),P=0.0002].Intrathecal dexmedetomidine had no effect on nausea and vomiting[RR=1.08,95%CI(0.68~1.71),P=0.74],bradycardia[RR=1.33,95%CI(0.31~5.76),P=0.70],and hypotension during cesarean section[RR=0.78,95%CI(0.59~1.03),P=0.08].Conclusion:Intrathecal dexmedetomidine can effectively reduce the occurrence of shivering during cesarean section,but it does not affect the occurrence of nausea and vomiting,bradycardia or hypotension.
作者
刘红辉
邓芳文
孙德贵
胡建华
廖国平
LIU Honghui;DENG Fangwen;SUN Degui;HU Jianhua;LIAO Guoping(Changning Hospital of Traditional Chinese Medicine,Changning 421500,China)
出处
《临床医药实践》
2020年第11期812-817,共6页
Proceeding of Clinical Medicine
关键词
右美托咪定
剖宫产术
腰麻
META分析
dexmedetomidine
cesarean section
spinal anesthesia
Meta analysis
作者简介
通信作者:廖国平;刘红辉(1975-),男,湖南省常宁市人,副主任药师,主要从事临床药学与医院中药新制剂研究工作。
