The Influence of Perioperative Dexmedetomidine on Patients Undergoing Cardiac Surgery: A Meta-Analysis.
The Influence of Perioperative Dexmedetomidine on Patients Undergoing Cardiac Surgery: A Meta-Analysis.
复制标题
围手术期右美托咪定对接受心脏手术的患者的影响：荟萃分析。
DOI：
10.1371/journal.pone.0152829
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Liu H
中科院分区：
文献类型：
--
作者：
Geng J;Qian J;Cheng H;Ji F;Liu H
使用右美托咪定可能对心脏手术的临床结果有好处。我们进行了一项荟萃分析，比较了右美托咪定与其他围手术期药物在心脏手术患者中的术后并发症，以确定右美托咪定对心脏手术患者围手术期的影响。从EMBASE、PubMed、Cochrane图书馆和科学引文索引中检索了随机或准随机对照试验，比较接受心脏手术的患者使用右美托咪定、另一种药物或安慰剂的结果。在符合研究策略的1535项研究中，14项研究中的1702例患者符合选择标准。与其他药物相比，右美托咪定室性心动过速的综合风险比为0.28(95%可信区间[CI] 0.15, 0.55, P = 0.0002)，术后谵妄的综合风险比为0.35 (95% CI 0.20, 0.62, P = 0.0004)，房颤的综合风险比为0.76 (95% CI 0.55, 1.06, P = 0.11)，低血压的综合风险比为1.08 (95% CI 0.74, 1.57, P = 0.69)，心动过缓的综合风险比为2.23 （95% CI 1.36, 3.67, P = 0.001）。此外，右美托咪定可以缩短重症监护病房（ICU）和住院时间。本荟萃分析显示，心脏手术患者围手术期使用右美托咪定可降低术后室性心动过速和谵妄的风险，但可能增加心动过缓的风险。估计结果显示右美托咪定可降低房颤的风险，缩短ICU住院时间，并增加低血压的风险。
The use of dexmedetomidine may have benefits on the clinical outcomes of cardiac surgery. We conducted a meta-analysis comparing the postoperative complications in patients undergoing cardiac surgery with dexmedetomidine versus other perioperative medications to determine the influence of perioperative dexmedetomidine on cardiac surgery patients. Randomized or quasi-randomized controlled trials comparing outcomes in patients who underwent cardiac surgery with dexmedetomidine, another medication, or a placebo were retrieved from EMBASE, PubMed, the Cochrane Library, and Science Citation Index. A total of 1702 patients in 14 studies met the selection criteria among 1,535 studies that fit the research strategy. Compared to other medications, dexmedetomidine has combined risk ratios of 0.28 (95% confidence interval [CI] 0.15, 0.55, P = 0.0002) for ventricular tachycardia, 0.35 (95% CI 0.20, 0.62, P = 0.0004) for postoperative delirium, 0.76 (95% CI 0.55, 1.06, P = 0.11) for atrial fibrillation, 1.08 (95% CI 0.74, 1.57, P = 0.69) for hypotension, and 2.23 (95% CI 1.36, 3.67, P = 0.001) for bradycardia. In addition, dexmedetomidine may reduce the length of intensive care unit (ICU) and hospital stay. This meta-analysis revealed that the perioperative use of dexmedetomidine in patients undergoing cardiac surgery can reduce the risk of postoperative ventricular tachycardia and delirium, but may increase the risk of bradycardia. The estimates showed a decreased risk of atrial fibrillation, shorter length of ICU stay and hospitalization, and increased risk of hypotension with dexmedetomidine.