普罗波和塞沃弗兰麻醉对视神经外的影响:系统性审查和元分析
Rodolfo Otávio Tomaz Bertti1, Luiz Antonio Vane1, José Mariano Soares de Moraes2
1Universidade Estadual Paulista (UNESP), Departamento de Especialidades Cirúrgicas e Anestesiologia, Botucatu, SP, Brazil.
Brazilian journal of anesthesiology (Elsevier)
|June 6, 2025
概括
与sevoflurane相比,propofol麻醉可能在机器人和腹腔镜骨盆手术期间降低高内压 (ICP). 视神经外直径 (ONSD) 超声波证实了这种ICP的减少,显示了用propofol显著减少.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 手术技术 手术技术
背景情况:
- 腹腔镜和机器人骨盆手术需要肺上皮质和Trendelenburg定位,可能会增加内压力 (ICP).
- 麻醉剂可以影响ICP.
- 视神经外直径 (ONSD) 超声波为估计ICP提供了一种非侵入性方法.
研究的目的:
- 系统地审查和评估ONSD作为ICP的间接措施.
- 为了比较sevoflurane与propofol对接受这些手术的患者的ONSD的影响.
主要方法:
- 对潜在的随机临床试验进行系统审查.
- 在文献中搜索的重点是ONSD评估在肺关节和Trendelenburg位置的sevoflurane或propofol麻醉下.
- 分析ONSD平均值和标准偏差,计算平均值差异和95%信心区间 (CI).
主要成果:
- 分析了五项随机对照试验,涉及277名受试者.
- 与基线 (p < 0.05) 相比,普罗波和塞沃兰在0.5至3小时之间增加了ONSD.
- 与西沃弗相比,普罗波显著减少了ONSD (平均差异: -0.23毫米,95%CI: -0.37至 -0.10).
结论:
- 超声波ONSD评估表明,醇可能比sevoflurane更有效地降低ICP.
- 研究结果表明,在腹腔镜/机器人骨盆手术期间,普罗波作为一种潜在的有利麻醉选择,可以最大限度地减少腹腔镜/机器人骨盆手术期间的ICP.
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