在胃肠内镜治疗中使用基于propofol的镇静剂的辅助esketamine:随机试验的系统审查和元分析
Jiazheng Qi1, Mengqiang Luo1, Wenru Zong1
1Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China.
在胃肠内镜检查中添加埃斯基他胺与普罗波镇静剂,可显著降低低血压和呼吸事件. 这种组合可以提高患者的安全性,而不会增加心血管风险或恢复时间.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 普罗波是胃肠道内学镇静的常见药物.
- 普罗波可以引起心血管和呼吸系统的副作用,缺乏止痛作用.
- 埃斯凯特胺提供镇静和止痛,具有最小的血液动力学影响,可能会改善普罗波福的安全性.
研究的目的:
- 系统地审查和对随机对照试验进行元分析,比较基于propofol的镇静剂与无静脉注射esketamine.
- 为了评估结合胃肠道内镜的esketamine与propofol的安全性和有效性.
主要方法:
- 18项随机对照试验的系统综述和元分析.
- 主要结局:低血压的发生率.
- 二次结局:呼吸事件,醇消耗,非自愿运动,高血压,心律失常,PONV,恢复时间和头.
主要成果:
- 素显著降低了低血压 (RR:0.32) 和呼吸系统不良事件 (RR:0.57).
- 观察到减少了非自愿运动 (RR:0.61) 和醇消耗 (MD: -0.94 mg/kg).
- 在高血压,心律失常,PONV,恢复时间或头方面没有显著差异.
结论:
- 补充醇镇静剂与乙胺降低了低血压和呼吸系统不良事件的风险.
- 这种组合似乎不会增加心血管并发症或延长恢复时间.
- 除了普罗波镇静剂外,Esketamine是胃肠内镜的潜在更安全,更有效的选择.
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