在基于德斯弗的麻醉中预防儿科突发狂妄症的预防:一个网络元分析
Hung-Chang Kuo1, Kuo-Chuan Hung2, Hung-Yu Wang3
1Department of Neurology, E-Da Hospital/School of Medicine, I-Shou University, Kaohsiung, Taiwan.
Journal of anesthesia
|July 5, 2023
概括
胺加上普罗波在经过德斯弗兰麻醉后的儿童中显著降低了术后出现的妄想. 与其他治疗相比,这种组合疗法显示出出现妄想的发病率最低.
科学领域:
- 麻醉学 麻醉学
- 儿科麻醉 儿科麻醉
- 药理学 药理学是指药理学的学科.
背景情况:
- 术后出现痴呆症 (pedED) 在儿童后的desflurane麻醉发生在50-80%的情况下.
- 现有的药理策略来预防pedED缺乏优越性的确证据.
- 普罗斯佩罗 CRD42021285200. 现在可以使用.
研究的目的:
- 评估个人药物疗法的预防效果和安全性,以预防在德斯弗麻醉后的PEDED.
- 为了比较各种药物治疗方案在减少 pedED 发生率和严重性的有效性.
- 为儿童患者提供基于证据的建议,以预防小儿ED.
主要方法:
- 随机对照试验 (RCT) 的一个频率模型网络元分析 (NMA).
- 包括具有安慰剂控制或活性控制设计的同行评审RCT.
- 专注于接受德斯弗兰麻醉的儿科患者.
主要成果:
- 分析了7项涉及573名参与者的研究.
- 与安慰剂相比,胺基 + 普罗波,单独使用德克斯梅德托米丁和普罗波显著降低了 pedED 的发生率.
- 胺 + 普罗波福尔显示了最低的pedED发生率; gabapentin显示了最低的pedED严重程度.
结论:
- 胺 + 普罗波福尔的使用表明,在研究的药理干预措施中,足部发电最少的发病率.
- 德克斯梅德托米丁和 gabapentin 在减少 pedED 发生率或严重程度方面也显示出显著的益处.
- 需要进一步的大规模试验来比较组合疗法以获得最佳的 pedED 预防.
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