异丙酚对比七氟烷应用于儿童手术麻醉安全性的Meta分析  

Safety of Propofol versus Sevoflurane for Children's Surgery:A Meta-analysis

作　　者：彭寒飞[1] 邹园[1] 李祯[1] 朱雅平[1] 

机构地区：[1]浙江省嘉兴市海盐县中医院麻醉科,浙江嘉兴314300

出　　处：《中国循证医学杂志》2016年第10期1201-1206,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统性评价异丙酚对比七氟烷应用于儿童手术麻醉的安全性,为儿科手术中麻醉药物的选择提供参考依据。方法计算机检索EMbase、Pub Med、The Cochrane Library、CSCD、CNKI和Wan Fang Data数据库,搜集异丙酚与七氟烷应用于儿童手术麻醉的随机对照试验(RCT),检索时限为各数据库建库至2015年1月。由两位研究者独立筛选文献、提取数据和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入15个RCT,包括1 065例患儿。Meta分析结果显示:与七氟烷相比,异丙酚能明显降低儿童术后麻醉苏醒期躁动的发生率[OR=0.23,95%CI(0.16,0.34),P<0.000 01]和术后呕吐发生率[OR=0.32,95%CI(0.20,0.51),P<0.000 01]。但在术后拔管时间[MD=0.98,95%CI(–0.26,2.21),P=0.12]、睁眼时间[MD=3.32,95%CI(–2.65,9.29),P=0.28]及止痛需求[OR=0.60,95%CI(0.30,1.23),P=0.16]方面,二者差异无统计学意义。结论在儿童手术麻醉过程中,与七氟烷相比,异丙酚能明显降低患儿术后苏醒期躁动及呕吐的发生,安全性更高。Objective To systematically review the safety of propofol versus sevoflurane for pediatric surgery. Methods EMbase, Pub Med, The Cochrane Library, CSCD, CNKI, Wan Fang Data were searched to collect randomized controlled trials（RCTs） about propofol versus sevoflurane for pediatric surgery from inception to January 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then metaanalysis was performed by using Rev Man 5. 3 software. Results Fifteen RCTs involving 1 065 children were included finally. Meta-analysis results showed that, compared with the sevoflurane group, the propofol group could reduce the incidence of emergence agitation（OR= 0. 23, 95 %CI 0. 16 to 0. 34, P〈0. 000 01） and the incidence of postoperative vomiting（OR= 0. 32, 95 %CI 0. 20 to 0. 51, P〈0. 000 01）. There were no significant differences between the two groups in extubation time（MD= 0. 98, 95 %CI – 0. 26 to 2. 21, P= 0. 12）, eye-opening time（MD= 3. 32, 95 %CI – 2. 65 to 9. 29, P= 0. 28） and postoperative analgesic requirements（OR= 0. 60, 95 %CI 0. 30 to 1. 23, P= 0. 16）. Conclusion In reducing the incidence of emergence agitation and postoperative vomiting, propofol is superior to sevoflurane, so propofol is safer than sevoflurane for children＇s surgery.

关 键 词：异丙酚 七氟烷 儿童手术 随机对照试验 META分析 

分 类 号：R726.1[医药卫生—儿科]