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, NY, USA.
概括
德克斯梅德托米丁 (Dexmedetomidine) 是用于内镜下层剖析 (ESD) 的辅助镇静剂,有效地减少了患者的不安. 虽然它不会影响切除率,但它会增加胸肌梗塞的风险,这表明ESD手术的潜在更安全的镇静选择.
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:
- 内镜下粘膜切割 (ESD) 对于去除胃肠变性病变至关重要.
- 在ESD手术中存在风险,包括疼痛和穿孔.
- 德克斯梅托米丁是一种α-2受体激动剂,可以作为ESD的辅助镇静剂提供抗焦虑和止痛的益处.
研究的目的:
- 系统地审查和元分析德克斯梅德托米丁作为ESD期间辅助镇静剂的疗效和安全性.
- 评估德克斯梅德托米丁对切除率,镇静时间和ESD程序中的不良事件的影响.
主要方法:
- 在Embase,Medline/PubMed,Scopus和Web of Science进行了系统的文献搜索,截至2024年4月21日,遵守PRISMA指南.
- 八项符合条件的研究比较德克斯梅德托米丁与其他ESD镇静剂被纳入使用RevMan.Man的随机效应模型元分析中.
- 分析的关键结果包括阻断和完全切除率,镇静时间和不良事件.
主要成果:
- 与对照组相比,德克斯梅德米丁没有显著改变 en-bloc 或完全切除率或镇静/手术时间.
- 使用德克斯梅德托米丁 (OR 0.15,95% CI:0.07至0.29) 观察到患者不安的显著减少.
- 心病发病率增加 (OR 7.15,95% CI 3.17至16.11),在使用德克斯梅德托米丁与普罗波福或米达佐拉姆的亚组中一致.
结论:
- 德克斯梅德托米丁是一种安全有效的ESD辅助镇静剂,主要是通过减少患者的不安.
- 胸肌梗塞的风险增加可能反映在手术期间生理压力减少.
- 需要进一步的研究来确定美德米丁的最佳剂量,并将其有效性与不同患者群体中的其他镇静剂进行比较.
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