麻醉术前应用美托咪啶与咪唑安定随机对照试验的Meta分析.pdfVIP

• 论  著  二次研究 2009, 9(11): 1231 1237 中国循证医学杂志 ～ 麻醉术前应用美托咪啶与咪唑安定 随机对照试验的Meta分析 孙捷豪  韩  宁  吴秀英* 中国医科大学盛京医院麻醉科（沈阳 110004 ） 摘要  目的 比较美托咪啶和咪唑安定用于麻醉术前给药的临床效果和安全性。方法 检索公开发表的关 于美托咪啶与咪唑安定用作麻醉前给药的所有随机对照试验，按Cochrane 系统评价的方法，选择试验、评价质量， 并采用RevMan4.2.10 软件进行Meta 分析。结果 共纳入 13 个研究，包括806 例患者。Meta 分析结果显示，美托 咪啶组与咪唑安定组相比能更好地降低术中的血压和心率，减少麻醉药使用量，缩短术后苏醒时间，减少术后寒颤 的发生率，但美托咪啶组在围术期低血压和心动过缓发生率明显高于咪唑安定组，恶心呕吐发生率两组间差异无 统计学意义。患者和手术医生对两者的满意度、术后镇静评分、以及术后需镇痛的人数，两者差异均无统计学意义。 结论 美托咪啶作为麻醉前用药与咪唑安定相比有优势，除了围术期低血压和心动过缓发生率较高以外，美托咪 啶有良好的临床效果和安全性。 关键词  美托咪啶；咪唑安定；随机对照试验 Dexmedetomidine versus Midazolam in Anesthetic Preoperative Administration: A Meta-analysis SUN Jie-hao, HAN Ning, WU Xiu-ying* Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, China Abstract Objective To carry out a meta-analysis to evaluate the efficacy and safety of dexmedetomidine in comparison with midazolam as preoperative drug. Methods All randomized controlled trials (RCTs) about dexmedetomidine as preoperative drug compared with midazolam were identified. Meta analysis was performed by using the statistical software RevMan 4.2.10 on the basis of strict quality evaluation. Results Thirteen RCTs involving 806 patients were included. The results of meta analyses showed that dexmedetomidine was better than midazolam in decreasing perioperative blood pressure and heart rate, decreasing dosage of anesthetics, shortening of emergence time, and decreasing the occurrence of agitation, while the occurrence of perioperative hypotention and bradycardia of dexmedetomidine was much more than midazolam. The statistical outcomes showed that there were no differences between the two drugs in the satisfactory score, postoperative sedation score, the numb