地佐辛预防小儿全麻苏醒期躁动的Meta分析

Efficacy and Safety of Dezocine for Emergence Agitation under General Anesthesia in Children: a Meta-Analysis

目的:系统评价地佐辛预防小儿全麻苏醒期躁动的有效性和安全性。方法:计算机检索Pub Med、EMBASE、Web of Science、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库及万方全文期刊数据库,收集地佐辛预防小儿全麻苏醒期躁动的随机对照试验,检索时间截止至2014年4月。采用Cochrane系统评价手册中文献质量评价标准评价纳入研究的文献质量,用Rev Man5.2软件进行Meta分析。结果:共纳入11个RCTs,各试验间基线均可比。Meta分析结果显示:在预防苏醒期躁动的有效性(躁动评分、躁动发生率)方面,地佐辛组优于生理盐水组、芬太尼组及舒芬太尼组,而与曲马多组比较差异无统计学意义;在不良反应发生率方面,地佐辛组低于芬太尼组和舒芬太尼组,与生理盐水组及曲马多组比较差异无统计学意义;不同剂量地佐辛比较,0.3 mg/kg剂量组与0.6 mg/kg剂量组在躁动评分及不良反应发生率方面差异无统计学意义。结论:地佐辛能明显改善小儿全麻苏醒期躁动情况,今后研究应关注其临床最佳使用剂量。

Objective： To systematically evaluate the clinical efficacy and safety of dezocine in prevent emergence agitation under general anesthesia in children. Methods： The following databases were searched for until April,2014 including Pub Med,EMBASE,Web of Science,CBM,CJFD,CSJD and Wanfang database. Then,randomized controlled trials of dezocine in prevent emergence agitation under general anesthesia in children were collected. The Cochrane Systematic Review Handbook was applied for assessing the quality of the collected trials,and Rev Man 5.2 was employed to conduct meta-analysis. Results： Eleven RCTs with comparable baseline were involved in this study. Meta-analysis showed that： when compared with the saline group,fentanyl group and sufentanil group,the dezocine group had a better effect on pediatric anesthesia emergence delirium（ PAED） and agitation incidence. However,there was no statistical difference between dezocine and tramadol. When mentioned to adverse event,the dezocine group had a lower incidence when compared with fentanyl group and sufentanil group. Meanwhile,there were no statistical differences when compared with tramadol and saline group. There were no statistically significant differences in PAED and adverse events between 0.3 mg / kg dose dezocine group and0.6 mg / kg dose dezocine group. Conclusion： Dezocine pediatric anesthesia could significantly improve postoperative agitation,the best use dose of dezocine should be focused on in future.