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镇静与全身麻醉用于切除心室节律失常:系统性审查和元分析
Shubh Patel1, Jiawen Deng1, Areeba Zubair1
1Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
镇静和全身麻醉 (GA) 在心室失常 (VA) 废除手术中表现出类似的结果. 然而,镇静可能会降低VA切除过程中的血液动力学不稳定性,尽管需要更多的研究.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
背景情况:
- 对于对药物无反应的患者,心室心律失常 (VA) 需要导管切除.
- 麻醉和镇静选择影响VA切除成功和安全.
- 了解最佳麻醉策略对于患者的治疗结果至关重要.
研究的目的:
- 为了比较镇静与全身麻醉 (GA) 的疗效和安全性,用于VA切除.
- 评估对手术成功,并发症和血液动力学稳定的影响.
主要方法:
- 观察性研究的系统审查和元分析.
- 从创立到2024年3月,搜索了五个数据库.
- 包括6项研究,包括16435名成年患者;ROBINS-I评估偏差风险,GRADE评估证据质量.
主要成果:
- 在手术时间,心律失常非诱导性,急性切除成功或并发症方面,镇静和GA之间没有显著差异.
- 镇静与明显较低的手术内血动力学不稳定性有关 (RR:0.28;95% CI:0.12-0.70).
结论:
- 镇静和GA为VA切除提供了可比的结果.
- 由于降低了血液动力学不稳定性,可能更喜欢镇静.
- 需要进一步的高质量研究来验证这些发现.
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