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神经肌肉阻断剂对儿科患者气管管道输液质量的影响:使用网络元分析和元回归的系统综述

Luc E Vanlinthout¹, Jacques J Driessen¹, Robert Jan Stolker¹

¹Department of Anaesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

British journal of anaesthesia

|October 11, 2025

概括

这次元分析发现,苏克萨米和罗库在儿童中提供类似的气管管道输液条件. 神经肌肉阻断剂 (NMBA) 改善了输管成功,益处随着年龄的增长而增加.

科学领域:

麻醉学麻醉学
药理学药理学是指药理学的学科.

背景情况:

儿科麻醉需要有效的气管管道输管.
神经肌肉阻断剂 (NMBAs) 对于输管至关重要.
在儿童中优化NMBA使用对于安全性和有效性至关重要.

研究的目的:

为了比较气管管道输液条件和儿童麻醉中各种NMBAs的血液动力学反应.
确定影响NMBA有效性和儿童输管治疗结果的因素.
为儿童呼吸道管理中NMBA选择和剂量提供基于证据的建议.

主要方法:

随机对照和对照临床试验的元分析,涉及健康儿童 (0-12岁).
对NMBA干预措施与用于气管管道输液的NMBA无设置进行比较.
贝叶斯网络和元回归分析以评估NMBA有效性和协变效应.

主要成果:

苏沙美和罗库在特定剂量 (分别为≥1.50 mg kg-1和≥0.90 mg kg-1) 时提供了类似的输管条件.
非去极化NMBA在较小的儿童中改善了输管条件,而NMBA的益处随着年龄的增长而增加.
阿片类药物降低了血液动力学参数,但在与足够的NMBA剂量相结合时,并没有改善输管条件.

结论:

NMBA类型,剂量,年龄和诱导药物显著影响儿科呼吸道管理的安全性和有效性.
这项研究提供了一个综合证据基础,用于优化NMBA在儿科输管治疗中的使用.
从这次元分析中得出的建议具有低至中等的可信度.

关键词:

年龄特定的影响.效果的比较效果的比较药物相互作用药物相互作用血动力学反应血动力学反应网络元分析网络元分析神经肌肉阻断剂是神经肌肉阻断剂儿科患者 (0~12岁)气管管道输入气管管道输入管道

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