单边和双边脊柱麻醉后的低血压:一个系统性审查与元分析
Cansheng Gong1, Xiuming Ye, Yanling Liao
1From the Department of Anaesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China (CG, YL, PY, TZ, XZ), the Library of Fujian Medical University, Fuzhou, China (XY), Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Key Laboratory of Critical Care Medicine, Fujian Provincial Co-Constructed Laboratory of "Belt and Road", Fuzhou, China (XZ).
与下肢和腹部手术的双边脊柱麻醉相比,单边脊柱麻醉显著降低了低血压. 然而,证据质量很低,需要谨慎地解释这些发现.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 临床试验 临床试验
背景情况:
- 脊柱麻醉在下肢手术中很常见,但通常会导致低血压.
- 建议单边脊髓麻醉来减少这种并发症,但证据仍在争论中.
研究的目的:
- 评估单边脊柱麻醉是否优于双边脊柱麻醉在降低低血压.
- 为了比较两种麻醉技术之间的其他并发症.
主要方法:
- 进行了随机对照试验 (RCT) 的元分析.
- 搜索的主要数据库 (PubMed,Embase,科学网,Cochrane) 截至2024年3月.
- 包括21个RCT,包括1358名患者,比较单边和双边脊柱麻醉.
主要成果:
- 单侧脊髓麻醉显示,低血压的发生率显著降低 (RR 0.38,95% CI 0.27-0.55).
- 这种减少在各种手术部位,剂量和低血压定义中是一致的.
- 在其他并发症方面没有详细说明任何显著差异.
结论:
- 单侧脊柱麻醉在下腹部和四肢手术中显著降低低血压.
- 根据GRADE评估,由于偏见和异质性,证据质量不佳.
- 结果应谨慎解释,尽管它们支持使用单边脊髓麻醉.
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