针灸复合全身麻醉的系统评价和Meta分析（英文）

Acupuncture-assisted general anesthesia: A systematic review and Meta analysis

目的:系统评价针灸复合麻醉对术中麻醉药使用量、苏醒时间的干预效应。方法:由两人按制定的检索策略独立对6个电子数据库进行文献检索截至2013年12月;按研究纳入和排除标准筛选符合要求针灸辅助麻醉临床试验;根据Cochrane Handbook指导两人独立使用Rev Man对每个符合纳入标准的临床试验进行偏倚风险和文献质量评估,并提取纳入研究的对象、方法和结果等资料;选取术中维持一定麻醉深度所使用的麻醉药品总量作为主要指标,术后苏醒时间为次要指标,条件符合时采取Meta分析。结果:最终纳入12项研究,包括979例患者,Meta分析结果均以均数差值(MD)和95%置信区间(CI)表示,静脉麻醉药丙泊酚用量为-59.29[-91.92,-26.67];苏醒时间中睁眼时间为-6.80[-10.50,-3.10]、气管插管拔除时间为-5.52[-8.06,-2.99]和术后手术恢复室撤离时间-11.46[-16.55,-6.37]。结论:针灸复合全身麻醉与常规全身麻醉相比,能减少静脉麻醉药品使用量和缩短麻醉苏醒时间。

Objective： This paper presented a systematic review and Meta analysis of acupuncture-assisted general anesthesia. Methods： Systematic literature searches of six electronic databases were performed from inception to December 2013 by two investigators. We included randomized controlled trials that evaluated the effects of acupuncture compared with a control （routine procedure） or a sham intervention in patients undergoing general anesthesia. Two reviewers selected eligible studies and evaluated the risk of bias and the quality of the acupuncture intervention. Information on methods, participants, interventions, and outcomes was extracted. The total consumption of anesthetics during surgery was selected as the primary index. Meta analysis of anesthetic recovery time was performed using random or fixed effects modeling. Results： Twelve trials that included 979 patients who received general anesthesia met the inclusion criteria. Results of pooled analyses indicated that compared with general anesthesia alone, acupuncture assistance significantly reduced the total dose of intravenous anesthetics needed （mean difference [95%CI], propofol （mg）, -59.29 [-91.92, -26.67] and the anesthetic recovery time （min） （-6.80[-10.50, -3.10], -5.52[-8.06, -2.99], -11.46[-16.55, -6.37]）. Conclusion： Compared with routine general anesthesia alone, acupuncture assistance reduces the dose of intravenous anesthetics and shortens anesthetic recovery time.