Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a meta-analysis of randomized controlled trials
Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a meta-analysis of randomized controlled trials
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DOI：
10.1007/s00540-013-1656-y
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发表时间：
2014-02-01
影响因子：
2.8
通讯作者：
Kurosawa, Shin
中科院分区：
文献类型：
--
作者：
Kanaya, Akihiro;Kuratani, Norifumi;Kurosawa, Shin
七氟醚对儿童全身麻醉后出现性躁动（EA）的不良反应有报道。我们描述了一项随机对照试验的荟萃分析，比较了七氟醚麻醉和异丙酚麻醉儿童EA的发生率。进行文献检索以确定符合我们纳入标准的临床试验。比较七氟醚和异丙酚麻醉在15岁以下儿童中的前瞻性随机试验被纳入meta分析。使用随机效应模型对每个试验的数据进行合并，计算合并优势比（or）及其相应的95%置信区间（ci）。采用Cochran's Q和I(2)检验评估数据的异质性。对研究质量、患者年龄和手术类型进行敏感性分析。荟萃分析包括14项研究，其中560例患者接受七氟醚治疗，548例接受异丙酚治疗。EA的合并OR为0.25,95% CI为0.16 ~ 0.39 (P = 0.000)，提示异丙酚麻醉导致EA发生率降低。数据的异质性无统计学支持（P = 0.191）。所有敏感性分析都强化了异丙酚降低EA发生率的证据。我们的荟萃分析表明，与七氟醚麻醉相比，异丙酚麻醉后儿童EA发生的可能性更小。
Emergence agitation (EA) from general anesthesia has been reported as an adverse effect of sevoflurane in children. We describe a meta-analysis of randomized controlled trials that compared the incidence of EA between children who underwent sevoflurane anesthesia and those who underwent propofol anesthesia.A literature search was conducted to identify clinical trials that met our inclusion criteria. Prospective randomized trials comparing sevoflurane and propofol anesthesia in children less than 15 years of age were included in the meta-analysis. Data from each trial were combined using the random effects model to calculate pooled odds ratios (ORs) and their corresponding 95 % confidence intervals (CIs). The heterogeneity of data was assessed by Cochran's Q and I (2) tests. Sensitivity analysis was conducted for study quality, patient age, and type of surgical procedure.The meta-analysis included 14 studies, in which 560 patients received sevoflurane and 548 received propofol. The pooled OR for EA was 0.25 with a 95 % CI of 0.16-0.39 (P = 0.000), which indicates that propofol anesthesia resulted in a lower incidence of EA. The heterogeneity of data was not statistically supported (P = 0.191). All sensitivity analyses strengthened the evidence for the lower incidence of EA with propofol.Our meta-analysis demonstrated that EA in children is less likely to occur after propofol anesthesia compared with sevoflurane anesthesia.