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华西医学  2011 

α2受体激动剂预防七氟烷引起小儿术后躁动的Meta分析

, PP. 1859-1863

Keywords: 可乐定,右美托咪啶,α2受体激动剂,七氟烷,小儿,术后躁动,Meta分析

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Abstract:

【】 目的 评价α2受体激动剂是否可以降低七氟烷引起的小儿术后躁动的发生率。 方法 通过检索Medline、荷兰医学文摘、Cochrane临床试验数据库、中国生物医学文献数据库和中国期刊网全文数据库等数据库,收集可乐定或右美托咪啶对七氟烷引起的小儿术后躁动的预防作用的随机对照试验(randomizedcontrolledtrial,RCT),提取资料和评估方法学质量,采用Cochrane协作网RevMan5.0软件进行Meta分析。 结果 最终纳入11个RCT,其中104例患儿预防性使用右美托咪啶,268例患儿使用可乐定,365例患儿使用安慰剂。Meta分析显示,可乐定组小儿术后躁动发生率的比值比(OR)为0.31,95%CI为(0.15,0.61)(P=0.0008);右美托咪啶组小儿术后躁动发生率的OR为0.16,95%CI为(0.08,0.31)(P<0.00001)。 结论 α2受体激动剂可以显著降低七氟烷引起的小儿术后躁动的发生率。【Abstract】 Objective Todeterminewhetheralpha2-adrenoceptoragonistscandecreaseemergenceagitation(EA)inpediatricpatientsaftersevofluraneanesthesia. Methods TheMedline,Embase,CochraneLibrary,CBMandCNKIweresearched.Allrandomizedcontrolledtrialscomparingclonidineordexmedetomidinewithotherinterventionsinpreventingemergenceagitationaftersevofluraneanesthesiawereretrieved.Studyselectionandassessment,datacollectionandanalyseswereundertaken.Meta-analysiswasdoneusingtheCochraneCollaborationRevMan5.0software. Results ElevenarticlesreachedourinclusioncriteriaandwereincludedintheMeta-analysis.Atotalof104childrentreatedwithdexmedetomidine,268childrentreatedwithclonidine,and365childrentreatedwithplacebowereevaluatedfortheincidenceofemergenceagitation.Thepooledoddsratiofortheclonidinesubgroupwas0.31,witha95%confidenceintervalof0.15-0.61(P=0.0008).Thepooledoddsratioforthedexmedetomidinesubgroupwas0.16,witha95%confidenceintervalof0.08-0.31(P<0.00001). Conclusion Alpha2-adrenoceptoragonistscansignificantlydecreasetheincidenceofemergenceagitationinpediatricpatientsaftersevofluraneanesthesia.

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