丙泊酚与硫喷妥钠在产妇全麻诱导中对新生儿影响的Meta分析

Influence of propofol and thiopentone on neonate in induction of anaesthesia of parturient: a meta-analysis

目的比较丙泊酚与硫喷妥钠在产妇全麻诱导中对新生儿的影响。方法系统检索:Pubmed、EMBASE、OVID、Cochrane Library、Web of science、万方等数据库及中国知网至2020年2月,收集丙泊酚与硫喷妥钠在产妇全麻诱导中对新生儿影响的随机对照试验,纳入文献质量采用Jadad方法评价,后以RevMan 5.3软件进行Meta分析。结果共纳入11个随机对照试验,共包括669例患者,其中丙泊酚组336例,硫喷妥钠组333例。纳入研究的方法学质量均较高,改良Jadad评分均在4分以上。Meta分析结果显示:与硫喷妥钠组相比,丙泊酚组的脐静脉血pH值稍低[WMD=-0.01,95%CI(-0.02,-0.01),P=0.0005],脐静脉血氧分压无显著差异[WMD=0.07,95%CI(-0.18,0.32),P=0.59],二氧化碳分压无显著差异[WMD=0.12,95%CI(-0.05,0.29),P=0.18];新生儿出生后1分钟及5 min Apgar评分均无显著差异[WMD=-0.10,95%CI(-0.16,0.22),P=0.78]。新生儿出生后15 min,2 h和24 h神经学和适应能力评分(NACS)均无显著差异,WMD=0.19,95%CI(-0.73,1.11),P=0.69。结论丙泊酚与硫喷妥钠用于孕产妇全麻诱导中新生儿的Apgar评分、NACS评分以及脐静脉血血气分析无显著差异。

Objective To compare the effects of propofol and thiopentone for induction of anaesthesia on neonate in parturient.Methods PubMed,Cochrane Library,EMBASE,OVID、Web of science,CNKI,Wanfang databases were searched to identify randomized controlled trials(RCTs)that compared propofol and thiopentone for induction of anaesthesia on neonate in parturient.The quality of the included RCTs was evaluated by Jadad,and meta-analysis was performed by RevMan 5.3 software.Results Eleven RCTs,including 669 patients were collected,including Popofol group with 336 patients,and thiopentone group with 333 patients.The methodological quality of them were all credible with over four scores evaluated by Jadad.The results of meta-analyses showed that the PH value of propofol was significantly higher than that of thiopentone[WMD=-0.01,95%CI(-0.02,-0.01),P=0.0005].In both groups,The PO 2 and PCO 2 values of umbilical vein were similar and in a normal interval,and the results of them were[WMD=0.07,95%CI(-0.18,0.32),P=0.59]and[WMD=0.12,95%CI(-0.05,0.29),P=0.18],respectively.There was no statistically significant difference in terms of the mean Apgar scores at the 1st and 5th minutes after the baby delivered[WMD=-0.10,95%CI(-0.16,0.22),P=0.78].It had no statistically significant difference in terms of Neurologic and Adapative Capacity Scores(NACS)at 15th minutes,2nd and 24th hours after the baby was delivered[WMD=0.19,95%CI(-0.73,1.11),P=0.69].Conclusion There is no statistically significant difference in NACS,Apgar scores and the umbilical vein blood gas values between propofol group and thiopentone group.