在接受腹部腹腔镜手术的成年人中发生深度神经肌肉阻塞
Veerle Bijkerk1,2, Lotte Mc Jacobs1, Kim I Albers2
1Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
The Cochrane database of systematic reviews
|January 30, 2024
概括
腹腔镜手术中的深度神经肌肉阻塞 (NMB) 与中度NMB相比,在生活质量和手术持续时间上可能几乎没有差异. 然而,关于死亡率和不良事件的证据仍然不确定,需要进一步研究.
科学领域:
- 麻醉学 麻醉学
- 手术创新 在外科创新.
- 临床试验 临床试验
背景情况:
- 腹腔镜手术需要防止患者的运动,以获得最佳的可视化.
- 深度神经肌肉阻塞 (NMB) 正在探索改善外科领域和减少术后疼痛.
- 关于深度NMB对手术内安全和临床结果的影响存在不确定性.
研究的目的:
- 评估深度神经肌肉阻塞 (NMB) 与没有,浅或中度NMB在经过腹腔镜手术的成年人中的益处和危害.
- 综合来自随机临床试验的证据,研究深度NMB对患者安全和康复的影响.
主要方法:
- 在2023年7月31日之前进行了全面的Cochrane搜索.
- 包括42个随机临床试验,其中3898名参与者将深度NMB与其他NMB水平进行了比较.
- 评估结果包括死亡率,生活质量,不良事件,疼痛和恢复,使用GRADE来确定证据的确定性.
主要成果:
- 与中度NMB相比,深度NMB可能在生活质量和手术持续时间上几乎没有差异.
- 有关深度NMB对死亡率和严重不良事件的影响的证据非常不确定.
- 不确定性也存在于非严重的不良事件,疼痛评分和再入院率,因为证据的确定性非常低.
结论:
- 与中度NMB相比,没有足够的证据可以得出深度NMB对死亡率和严重不良事件的影响.
- 深度NMB与中度NMB相比,在生活质量和手术持续时间上几乎没有差异;对住院的影响尚不确定.
- 需要进一步进行高质量的随机临床试验,以澄清深度NMB对各种患者结果的影响.
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