国际麻醉学与复苏杂志   2016, Issue (4): 0-0
    
椎管内给药预防剖宫产术中寒战的Meta分析
曾丽, 高鸿, 林少锋, 刘艳秋1()
1.贵州医科大学
Intrathecal drugs for preventing shivering in cesarean section: a Meta-analysis
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摘要:

目的 评价椎管内给药预防剖宫产术中寒战的有效性与安全性。 方法 检索Cochrane图书馆、PubMed、Embase,检索时间从建库至2015年8月。收集椎管内给药预防剖宫产术中寒战的临床随机对照试验(RCTs)。采用Cochrane协作网系统评价法评价纳入文献的质量,采用RevMan 5.3软件对收集的资料进行Meta分析。 结果 纳入10项研究,共677例,其中试验组390例,对照组287例。与对照组比较,分别体现在芬太尼、哌替啶可减少术中寒战的发生,合并效应的比值比(odda radio, OR)和95%可信区间(95%confidence interval, 95%CI)为(OR=0.29,95%CI 0.14~0.59)、(OR=0.09,95%CI 0.04~0.18)、舒芬太尼椎管内给药与对照组比较,并不能减少术中寒战的发生(OR=1.74,95%CI 0.33~9.02)。 结论 芬太尼、哌替啶椎管内给药可有效且安全预防剖宫产术中寒战的发生,而舒芬太尼椎管内给药可能并不能减少术中寒战的发生;在椎管内给予上述药物时应注意药物相关并发症。

关键词: 鞘内注射; 剖宫产; 寒战; Meta分析
Abstract:

Objective To evaluate the efficacy and safety of intrathecal drugs for preventing shivering in cesarean section. Methods We searched the Cochrane Library, PubMed, Embase, for all the randomized controlled trials(RCTs) about intrthecal drugs for preventing shivering in sesarean section. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan5.3 software. Results Ten original RCTs investgating a total of 677 patients, of whom 390 received target drugs and 287 received placebo, met the inclusion criteria. Compared to the placebo group, fentanyl and meperidine can reduce the incidence of shivering in cesarean section(OR=0.29,95%CI 0.14-0.59),(OR=0.09,95%CI 0.04-0.18), sufentanil may not reduce incidence of shivering in cesarean section(OR=1.74,95%CI 0.33-9.02). Conclusions Fentanyl and meperidine intrathecal drugs can effectively and safely reduce the incidence of shivering in cesarean section, sufentanil may not reduce shivering in cesarean section, and attentions should be paid to complications which related to intrathecal drugs.

Key words: Intrathecal; Cesarean section; Shivering; Meta-analysis