Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands
Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands
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DOI：
10.1007/s12630-011-9519-1
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发表时间：
2011-08-01
影响因子：
4.2
通讯作者：
Ledolter, Johannes
中科院分区：
文献类型：
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作者：
Wachtel, Ruth E.;Dexter, Franklin;Ledolter, Johannes
目的我们进行了一项荟萃分析，以比较地氟醚与丙泊酚的手术室恢复时间。方法研究包括：a）将人随机分配到丙泊酚或地氟醚组，组间无其他差异（例如，诱导药物）和B）平均值和标准差报告拔管时间和/或遵循命令的时间。由于在对数标尺中治疗组之间存在方差异质性（即，时间尺度上观察值的变异系数不等），对数正态分布的广义关键方法被用作随机效应荟萃分析的输入。与丙泊酚相比，拔管时间的变异性降低了26%（95%置信区间[CI]，6%-42%; P = 0.006），并且遵循指令时间的变异性降低了39%（95% CI，25%-51%; P < 0.001）。地氟烷使平均拔管时间缩短了21%（95% CI，9%至32%; P = 0.001），并将遵循命令的平均时间缩短了23%（95% CI，16%至30%; P < 0.001），但不影响正常工作。结论地氟烷相对于丙泊酚手术室恢复时间的平均减少与先前地氟烷相对于丙泊酚手术室恢复时间的平均减少相当。七氟烷变异性的降低幅度超过七氟烷。机构在做出循证药物经济学决策时可以使用百分比差异。
Purpose We performed a meta-analysis to compare the operating room recovery time of desflurane with that of propofol.Methods Studies were included in which a) humans were assigned randomly to propofol or desflurane groups without other differences between groups (e.g., induction drugs) and b) mean and standard deviation were reported for extubation time and/or time to follow commands. Since there was heterogeneity of variance between treatment groups in the log-scale (i.e., unequal coefficients of variation of observations in the time scale), generalized pivotal methods for the lognormal distribution were used as inputs of the random effects meta-analyses.Results Desflurane reduced the variability (i.e., standard deviation) in time to extubation by 26% relative to propofol (95% confidence interval [CI], 6% to 42%; P = 0.006) and reduced the variability in time to follow commands by 39% (95% CI, 25% to 51%; P < 0.001). Desflurane reduced the mean time to extubation by 21% (95% CI, 9% to 32%; P = 0.001) and reduced the mean time to follow commands by 23% (95% CI, 16% to 30%; P < 0.001).Conclusions The mean reduction in operating room recovery time for desflurane relative to propofol was comparable with that shown previously for desflurane relative to sevoflurane. The reduction in variability exceeded that of sevoflurane. Facilities can use the percentage differences when making evidence-based pharmacoeconomic decisions.