德克斯梅德托米丁作为在接受内镜下粘膜剖析的患者中辅助镇静剂:系统性审查和元分析
Hazem Abosheaishaa1, Abdallfatah Abdallfatah2, Abdelmalek Abdelghany2
1Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals, Queens, New York, USA.
medRxiv : the preprint server for health sciences
|December 16, 2024
概括
德克斯梅德托米丁是一种安全有效的辅助镇静剂,用于内镜下层剖析 (ESD),减少患者的不安. 虽然它增加了胸风险,但它不会影响切除率,为胃肠道手术提供了一个有前途的选择.
科学领域:
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 内镜下粘膜剖析 (ESD) 是对失塑性胃肠病变的治疗方法.
- 术后不良事件 (AE) 如疼痛,出血和穿孔在ESD后很常见.
- 德克斯梅德托米丁是一种α-2受体激动剂,提供焦虑溶解和止痛作用,使其成为ESD潜在的辅助镇静剂.
研究的目的:
- 评估德克斯梅德托米丁作为内镜下膜剖析 (ESD) 的辅助镇静剂的疗效和安全性.
- 评估其对切除率,手术时间和不良事件的影响.
主要方法:
- 一个系统的审查和八项研究的元分析涉及ESD与德克斯梅德托米丁作为辅助镇静剂.
- 数据提取和偏差风险评估是独立进行的.
- 进行了元分析,使用随机效应模型.
主要成果:
- 德克斯梅德米丁没有显著改变阻断或完全切除率或手术时间.
- 它显著减少了患者的不安 (OR 0.15).
- 观察到肌心率显著增加 (OR 7.15),可能表明生理压力减少.
结论:
- 德克斯梅德托米丁是一种安全有效的ESD辅助镇静剂,有效减少不安.
- 肌心风险增加需要监测,但可能反映了生理压力降低.
- 需要进一步研究最佳剂量和对其他镇静剂的有效性进行比较.
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