Dexmedetomidine Versus Morphine or Fentanyl in the Management of Children After Tonsillectomy and Adenoidectomy: A Meta-analysis of Randomized Controlled Trials
Dexmedetomidine Versus Morphine or Fentanyl in the Management of Children After Tonsillectomy and Adenoidectomy: A Meta-analysis of Randomized Controlled Trials
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右美托咪定与吗啡或芬太尼在扁桃体切除和腺样体切除术后儿童治疗中的比较：随机对照试验的荟萃分析
DOI：
10.1177/000348941312200207
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发表时间：
2013-02-01
影响因子：
1.4
通讯作者：
Zhang, Hao
中科院分区：
文献类型：
--
作者：
He, Xing-Ying;Cao, Jian-Ping;Zhang, Hao
目的：本综述的主要目的是评价和比较盐酸右美托咪定与阿片类药物在儿童扁桃体切除术和腺样体切除术后治疗中的疗效和安全性。方法：我们在Cochrane图书馆（最新一期）、Medline（1966年至今）、Embase（1980年至今）和Web of Science（1945年至今）中检索Cochrane中央对照试验注册库（Central）。分析麻醉后护理单元中需要急救镇痛药（吗啡或芬太尼）的患者数量、出现急急不安的患者数量、术后恶心和呕吐的患者数量、对言语刺激睁大眼睛的时间、拔管时间。结果：纳入5项试验，共纳入482例患者。右美托咪定组与阿片类药物组在麻醉后护理单元需要急救镇痛药的患者数量、出现躁动的患者数量、术后恶心呕吐的患者数量、拔管时间等方面均无显著差异。与阿片类药物相比，右美托咪定与言语刺激下睁眼时间显著缩短相关（平均差值为-2.11分钟；95%可信区间为-3.32至-0.91分钟；p = 0.0006）。结论：术中使用右美托咪定与阿片类药物在预防扁桃体和腺样体切除术患儿术后疼痛和出现性躁动方面具有同等效果。
Objectives: The primary objective of this review was to evaluate and compare the efficacy and safety of dexmedetomidine hydrochloride with the efficacy and safety of opioids for postoperative management of children after tonsillectomy and adenoidectomy.Methods: We searched the Cochrane Central Register of Controlled Trials (Central) in the Cochrane Library (most recent issue), Medline (1966 to date) through Ovid, Embase (1980 to date), and Web of Science (1945 to date). The number of patients who required rescue analgesics (morphine or fentanyl) in the postanesthesia care unit, the number of patients with emergence agitation, the number of patients with postoperative nausea and vomiting, the time to eye-opening in response to verbal stimuli, and the time to extubation were analyzed.Results: We included 5 trials, consisting of 482 patients in total. There were no significant differences in the number of patients who required rescue analgesics in the postanesthesia care unit, the number of patients with emergence agitation, the number of patients with postoperative nausea and vomiting, or the time to extubation between patients who received dexmedetomidine and those who received opioids. Compared with opioids, dexmedetomidine was associated with a significantly decreased time to eye-opening in response to verbal stimuli (mean difference, -2.11 minutes; 95% confidence interval, -3.32 to -0.91 minutes; p = 0.0006).Conclusions: Intraoperative use of dexmedetomidine was as effective as opioids in preventing postoperative pain and emergence agitation in children who had undergone tonsillectomy and adenoidectomy.