Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: A meta-analysis with trial sequential analysis of randomized controlled trials
Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: A meta-analysis with trial sequential analysis of randomized controlled trials
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右美托咪定与丙泊酚镇静可减少心脏手术后患者的谵妄：一项随机对照试验序贯分析的荟萃分析
DOI：
10.1016/j.jcrc.2016.10.026
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发表时间：
2017-04-01
影响因子：
3.7
通讯作者：
Fang, Xiangming
中科院分区：
文献类型：
--
作者：
Liu, Xu;Xie, Guohao;Fang, Xiangming
目的：右美托咪定用于心脏手术后患者的镇静效果是否优于丙泊酚尚不确定。本荟萃分析的目的是比较右美托咪定和丙泊酚镇静对成人患者心脏surgery.Methods后的结果的影响：随机对照试验比较结果与右美托咪定或丙泊酚镇静的心脏手术患者检索PubMed，Embase，Web of Science，科克伦图书馆和临床试验。结果：8项研究共969例患者符合入选标准。结果显示，右美托咪定与较低的谵妄风险相关，（风险比，0.40;95%置信区间[CI]，0.24-0.64; P = .0002），插管长度较短（小时;平均差异，-0.95; 95%CI，-1.26至-0.64; P < .00001），但心动过缓的发生率较高（风险比3.17; 95% CI，1.41-7.10; P = .005）。右美托咪定和丙泊酚镇静方案之间的低血压或房颤的发生率或重症监护室停留时间无统计学差异。结论：右美托咪定镇静可以减少术后谵妄，并与较短的插管时间相关，但与丙泊酚相比，可能会增加心脏手术后患者的心动过缓。(C)2016作者爱思唯尔公司出版
Purpose: It is uncertain whether dexmedetomidine is better than propofol for sedation in postcardiac surgery patients. The purpose of this meta-analysis was to compare the effects of dexmedetomidine and propofol sedation on outcomes in adult patients after cardiac surgery.Methods: Randomized controlled trials comparing outcomes in cardiac surgery patients sedated with dexmedetomidine or propofol were retrieved from PubMed, Embase, Web of Science, the Cochrane Library, and Clinicaltrials. Gov until May 23, 2016.Results: A total of 969 patients in 8 studies met the selection criteria. The results revealed that dexmedetomidine was associated with a lower risk of delirium (risk ratio, 0.40;95% confidence interval [CI], 0.24-0.64; P = .0002), a shorter length of intubation ( hours; mean difference, -0.95; 95% CI, -1.26 to -0.64; P < .00001), but a higher incidence of bradycardia ( risk ratio 3.17; 95% Cl, 1.41-7.10; P = .005) as compared to propofol. There were no statistical differences in the incidence of hypotension or atrial fibrillation, or the length of intensive care unit stay between dexmedetomidine and propofol sedation regimens.Conclusions: Dexmedetomidine sedation could reduce postoperative delirium and was associated with shorter length of intubation, but might increase bradycardia in patients after cardiac surgery compared with propofol. (C) 2016 The Authors. Published by Elsevier Inc.