心脏手术患者瑞芬太尼复合麻醉与芬太尼或舒芬太尼复合麻醉效果的比较：Meta分析  

Comparison of efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery： a Meta-analysis

作　　者：李肇端[1] 周汾[1] 闫雨苗[1] 董树安[1] 余剑波[1] 

机构地区：[1]天津市南开医院麻醉科,300100

出　　处：《中华麻醉学杂志》2012年第7期860-862,共3页Chinese Journal of Anesthesiology

摘　　要：目的采用Meta分析比较心脏手术患者瑞芬太尼复合麻醉与芬太尼或舒芬太尼复合麻醉的效果。方法检索Cochrane图书馆、PubMed、EMBASE、OVID和中国生物医学文献数据库，收集心脏手术患者瑞芬太尼复合麻醉与芬太尼或舒芬太尼复合麻醉效果比较的临床随机对照研究。采用Cochrane协作网系统评价法评价纳入文献的质量，评价指标包括：术后机械通气时间、总住院时间和围术期心肌肌钙蛋白水平、病死率、正性肌力药使用率、痛觉过敏发生率和心肌梗死发生率。采用RevMan5．0软件进行Meta分析。结果共纳入16项研究，包括1473例患者，其中芬太尼组或舒芬太尼组664例，瑞芬太尼组573例。与芬太尼组或舒芬太尼组相比，瑞芬太尼组术后机械通气时间和总住院时间缩短，围术期心肌肌钙蛋白水平和正性肌力药物使用率降低（P〈0．05），围术期病死率、痛觉过敏和心肌梗塞的发生率差异无统计学意义（P〉0．05）。结论心脏手术患者瑞芬太尼复合麻醉的效果优于芬太尼或舒芬太尼复合麻醉。Objective To compare the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery. Methods We searched the Cochrane library, PubMed, EMBASE, OVID and Chinese Biomedical Database for prospective randomized controlled trials involving the comparison of the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Evaluation indexes included the mechanical ventilation time after Operation, duration of stay in hospital, and level of cardiac troponin, mortality, requirement for positive inotropic drugs and incidence of hyperalgesia and myocardial infarction during perioperative period. Meta-analysis was conducted using the RevMan 5.0 software. Results Sixteen prospective randomized Controlled trials involving 1473 patients were included in our Meta-analysis. The patients were divided into 2 groups： fentanyl or sufentanil group （ n = 644） and remifentanil group （ n = 573）. Compared with fentanyl or sufentanil group, the mechanical ventilation time after operation and duration of stay in hospital were significantly shortened, the level of cardiac troponin during the perioperative period was significantly decreased and the requirement for positive inotropic drugs during the perioperative period was sig- nificantly reduced （ P 〈 0.05）, and no significant change was found in the incidence of hyperalgesia or mortality of myocardial infarction during the perioperative period in remifentanil group （ P 〉 0.05 ）. Conclusion The efficacy of remifentanil combined anesthesia is better than that of fentanyl or sufentanil combined anesthesia in patients un- dergoing cardiac surgery.

关 键 词：哌啶类 芬太尼 舒芬太尼 心脏外科手术 META分析 

分 类 号：R614[医药卫生—麻醉学]