右美托咪定对妇科腹腔镜手术患者术后恢复期影响的meta分析

Effect of dexmedetomidine on postoperation in recovery period for patients undergoing laparoscopic surgery:a meta analysis

目的系统评价右美托咪定对妇科腹腔镜手术患者术后恢复期的影响。方法计算机检索Pub Med、The Cochrane Library、Springer、CBM、CNKI、VIP、Wan-Fang Data,查找有关右美托咪啶用于妇科腹腔镜手术患者恢复期影响的随机对照试验(RCT),同时追溯纳入文献的参考文献。对符合纳入标准的文献进行质量评价和资料提取,采用Rev Man5.2软件进行meta分析。结果共纳入11个RCT,741例患者。meta分析显示:与生理盐水相比,右美托咪定能降低妇科腹腔镜手术患者术后恶心呕吐发生率[OR=0.33,95%CI(0.20,0.53),P<0.000 01]、术后寒战发生率[OR=0.26,95%CI(0.13,0.53),P=0.000 2]以及躁动的发生率[OR=0.14,95%CI(0.08,0.24),P<0.000 01]。但对于术后恢复期苏醒时间[MD=-6.02,95%CI(-31.01,18.97),P=0.64]、拔管(或移除喉罩)时间[MD=-0.89,95%CI(-2.57,0.79),P=0.30],两组情况无显著性差异。结论右美托咪定能降低妇科腹腔镜手术患者术后恶心呕吐、寒战和躁动的发生率,对苏醒时间、拔管(或移除喉罩)时间无显著影响。

Objective To evaluate the influence of dexmedetomidine on the postoperative recovery of patients receiving laparoscopic surgery. Methods The data of randomized controlled trials（ RCTs） about the influence of dexmedetomidine on the recovery of patients after receiving laparoscopic surgery were collected by searching Pub Med,the Cochrane Library,Springer,CBM,CNKI,VIP,and Wan Fang Data. Rev Man 5. 2 was used for meta-analysis. Results A total of 11 RCTs involving 741 patients were included. The results showed that dexmedetomidine reduced the occurrence of postoperative nausea and vomiting compared with normal saline[OR =0. 33,95% CI（ 0. 20,0. 53）,P〈0. 000 01],the incidence of postoperative shivering[OR = 0. 26,95% CI（ 0. 13,0. 53）,P = 0. 000 2]and the occurrence of emergence agitation[OR = 0. 14,95% CI（ 0. 08,0. 24）,P〈0. 000 01]. But there was no significant difference for the emergence time[MD =- 6. 02,95% CI（- 31. 01,18. 97）,P = 0. 64]and extubation time[MD =- 0. 89,95% CI（- 2. 57,0. 79）,P = 0. 30]between dexmedetomidine group and control group. Conclusion Dexmedetomidine can reduce the occurrence of postoperative nausea and vomiting,postoperative shivering and emergence agitation,but it shows no significant influence on emergence time and extubation time（ or the time of using the laryngeal mask）.