老年患者术前应用戊乙奎醚和阿托品的系统评价

Preoperative Use of Penehyclidine vs.Atropine in Elderly Patients:A Systematic Evaluation

目的:比较老年患者术前应用戊乙奎醚和阿托品的临床效果。方法:检索公开发表的关于戊乙奎醚和阿托品用于老年患者麻醉前给药的所有随机、对照试验,按Cochrane系统评价的方法,选择试验、评价质量,并采用RevMan5.0软件进行Meta分析。结果:共纳入11个研究,包括628例患者。Meta分析结果显示,戊乙奎醚组与阿托品组在口干VAS评分、SPO2指标方面未见统计学差异(P>0.05);SBP、DBP和HP指标具有统计学差异(P<0.05)。结论:老年患者术前用戊乙奎醚在抑制唾液分泌、保障呼吸道通畅的作用与阿托品相似,但对心率、血压的影响很小,更适合老年患者作为麻醉前用药。

OBJECTIVE： To evaluate the clinical efficacy of penehyclidine vs. atropine used preoperatively in elderly patients. METHODS： All the randomized controlled trials （RCTs） on preanesthetic medication of penehyclidine vs. atropine in elderly patients were retrieved for trial selection and quality evaluation using Cochrane systematic evaluation, meanwhile, a meta-analysis was performed using RevMan5. 0 software. RESULTS： 11 RCTs （628 cases） were collected. Meta-analysis revealed no statistical differences between penehyclidine and atropine with regard to VAS scores and SPO2 （P 〉 0.05 ）. However, there were statistical differences between penehyclidine and atropine with regard to SBP, DBP and HP （P 〈 0.05）. CONCLUSION： Therefore, penehyclidine was similar to atropine in inhibiting saliva secretion and maintaining smooth respiratory tract in elderly patients, but penehyclidine had little impact on heart rate and blood pressure, which thus is more optimal in preanesthetic medication for elderly patients.