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在神经麻醉中绘制高水平证据:对神经外科麻醉多中心随机对照试验的范围审查

Mouad Elganga¹, Abramo Aziz Rizk², Tumul Chowdhury^3,4

¹Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3K3, Canada.

Journal of clinical medicine

|March 14, 2026

概括

神经麻醉的多中心试验是有限的,专注于短期结果. 需要更强大的研究来评估以患者为中心的结果,以改善内神经外科护理.

科学领域:

神经外科神经外科
麻醉学麻醉学
临床试验临床试验

背景情况:

内神经外科手术需要精确的麻醉,因为大脑对生理变化的敏感性.
目前的神经麻醉的实践显示变化和缺乏强有力的证据.
多中心随机对照试验 (RCT) 对于推进神经麻醉至关重要.

研究的目的:

在内神经外科手术中绘制和描述术前管理的多中心RCT.
确定研究缺口,并为未来的临床试验设计提供信息.
评估神经麻醉现有高级别证据的范围和重点.

主要方法:

根据PRISMA扩展指南进行范围审查.
在主要数据库 (MEDLINE,PubMed,EMBASE,Cochrane,Web of Science) 中进行全面的搜索.
包括多中心RCT评估成人内神经外科手术患者的麻醉,血液动力,呼吸或外科外科手术.

主要成果:

确定了13个多中心RCT (2765名参与者,9个国家,1997-2025年).
大多数试验集中在麻醉维持,阿片类药物治疗方案和疼痛控制上.
结果主要是短期和基于过程的;以患者为中心和长期结果很少被评估.

结论:

在神经麻醉中,多中心RCT的活性稀疏且重点狭窄.
现有的试验往往具有高偏差风险.
迫切需要进行更大规模的,在方法上健全的试验,以解决神经麻醉中以患者为中心的和长期的结果.

关键词:

多中心随机对照试验多中心随机对照试验神经麻醉是一种神经麻醉.神经外科神经外科手术在外科手术期间的护理.范围审查范围审查审查

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