德克斯梅德托米丁用于清醒的头骨切除术:系统审查和元分析
Phuping Akavipat1, Pimwan Sookplung1, Varinee Lekprasert2
1Department of Anesthesiology, Neurological Institute of Thailand, Bangkok 10400, Thailand.
概括
基于德克斯梅德托米丁的监控麻醉护理 (MAC) 是有效的和安全的清醒的头骨切除术. 这次系统性审查没有发现结果的显著差异,但注意到使用德克斯梅德托米丁的手术内发作较少.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 基于证据的医学基于证据的医学.
背景情况:
- 监控麻醉护理 (MAC) 是由于较低的失败率,更喜欢醒着的头骨切除术.
- 在醒着的骨切除术中,MAC的最佳麻醉剂和并发症概况仍然不清楚.
研究的目的:
- 系统地审查和比较基于德克斯梅托米丁的临床概况,手术结果和麻醉相关并发症与非德克斯梅托米丁治疗方案在MAC下进行清醒的瘤切除.
主要方法:
- 从PubMed,Scopus,Google Scholar和灰色文献中发表的临床试验 (2009年1月至2022年3月) 的系统审查和元分析.
- 包括2,137名接受手术,深度大脑刺激或在雄辩区域附近进行内手术的患者.
- 遵循PRISMA指南与PROSPERO注册;比较结果和并发症的相对风险 (RR).
主要成果:
- 在手术结果 (RR 1.08),转换为全身麻醉 (RR 0.45),呼吸道并发症 (RR 0.4) 或手术内恶心/吐 (RR 0.30) 中没有发现统计学上显著的差异.
- 在非德克斯梅托米丁组中,手术期间发作的发生率明显高于非德克斯梅托米丁组 (RR 4.26).
结论:
- 基于德克斯梅德托米丁的MAC似乎是有效和安全的清醒的骨切除术.
- 需要使用标准化方案进行进一步的随机对照试验,以确认德克斯梅德托米丁在各种患者群体和手术过程中的特定益处.
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