围术期导尿时机对全麻患者苏醒期躁动影响的Meta分析

Effect of catheterization timing on restlessness in patients undergoing general anesthesia:a Meta-analysis

目的探讨围手术期不同导尿时机对全麻患者苏醒期躁动的影响,以期为选择最佳手术导尿时机提供科学依据。方法计算机检索中国知网、维普、万方数据库、中国生物医学数据库、Pubmed、Cochrane library、Embase、Medline等数据库从建库至2020年4月相关随机对照试验,由2名研究人员根据要求独立进行筛选文献、提取资料,并按Cochrane网5.1.0版手册进行质量评价,采用RevMan5.3软件对数据进行Meta分析。结果共纳入9项随机对照试验,762例研究对象,Meta分析结果显示,麻醉诱导期导尿和全麻后导尿苏醒期躁动发生率[RR=0.37,95%CI(0.30,0.46),P<0.001]、导尿时收缩压[WMD=-2.08,95%CI(-4.09,-0.07),P=0.04]比较差异具有统计学意义;麻醉诱导期导尿和全麻后导尿苏醒期的患者舒适度[RR=1.15,95%CI(0.93,1.43),P=0.19]、导尿时舒张压[WMD=2.23,95%CI(-1.45,5.90),P=0.24]比较差异无统计学意义。结论麻醉诱导期导尿可明显降低患者全麻苏醒期躁动的发生,减轻导尿后疼痛,促进患者病愈。

Objective To explore the effect of different catheterization time on restlessness in patients with general anesthesia during perioperative period,so as to provide scientific basis for selecting the best time of urethral catheterization.Methods We searched CNKI,VIP,Wanfang database,China biomedical database,PubMed,Cochrane Library,EMBASE and MEDLINE.Objective to search for relevant randomized controlled trials from the establishment of the database to April 2020.Two researchers independently screened the literature and extracted the data according to the requirements,and evaluated the quality according to Cochrane 5.1.0 manual.The data were analyzed by Revman 5.3 software.Results A total of 9 randomized controlled trials involving 762 subjects were included.The results of meta-analysis showed that the incidence of agitation during catheterization during anesthesia induction and after catheterization after general anesthesia[RR=0.37,95%CI(0.30,0.46),P<0.001],systolic blood pressure during catheterization[WMD=-2.08,95%CI(-4.09,0.001)],-There was no significant difference in comfort(RR=1.15,95%CI(0.93,1.43),P=0.19]and diastolic blood pressure[WMD=2.23,95%CI(-1.45,5.90),P=0.24]in patients during induction of anesthesia and after general anesthesia.Conclusion During anesthesia induction period,catheterization can significantly reduce the emergence of agitation,relieve the pain after catheterization,promote the recovery of patients,and improve the comfort of patients during recovery period,which can be further promoted in clinical practice.