舒芬太尼复合罗哌卡因用于剖宫产蛛网膜下腔阻滞麻醉阻滞效果的Meta分析  

The effectiveness of combination of ropivacaine with sufentanil for spinal anesthesia in cesarean section: a meta-analysis

作　　者：黄健 王丰 周菁 高鸿 HUANG Jian;WANG Feng;ZHOU Jing(Department of Anesthesiology, The Third People's Hospital of Guizhou Province, Guiyang 550008, China;Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China)

机构地区：[1]贵州省第三人民医院麻醉科,贵州贵阳550008 [2]贵州医科大学附属医院麻醉科,贵州贵阳550004

出　　处：《吉林医学》2018年第12期2207-2211,共5页Jilin Medical Journal

基　　金：贵州省教育厅自然科学基金[项目编号:黔教科(2011)038号];贵州省中医药管理局基金资助[项目编号:QZYY2017-032];贵州医科大学麻醉学专业学位研究生工作站[项目编号:080800818]

摘　　要：目的:系统评价舒芬太尼复合罗哌卡因与单纯罗哌卡因用于剖宫产蛛网膜下腔阻滞麻醉的阻滞效果。方法:计算机检索万方、知网、维普、Pub Med、Embase、Cochrane library,查找舒芬太尼复合罗哌卡因与单用罗哌卡因进行剖宫产蛛网膜下腔阻滞麻醉的随机对照实验(randomized controlled trial,RCT),同时追溯纳入文献的参考文献。对符合纳入标准的文献进行质量评价和资料提取,采用Rev Man5. 3软件进行Meta分析。结果:最终纳入10项RCT,共856例患者。Meta分析结果显示:(1)主要结局指标:试验组的感觉阻滞起效时间[SMD=-1. 01,95%CI(-1. 63,-0. 40),P <0. 05]和运动阻滞完全时间[SMD=-0. 47,95%CI(-0. 75,-0. 18),P <0. 05]均短于对照组;试验组感觉和运动阻滞恢复时间均长于对照组分别为[SMD=1. 13,95%CI(0. 51,1. 74),P <0. 05]、[SMD=0. 51,95%CI(0. 11,0. 91),P <0. 05]。(2)次要结局指标:试验组的瘙痒发生率高于对照组[SMD=13. 27,95%CI(6. 21,28. 33),P <0. 05];两组恶心、呕吐发生率差异无统计学意义(P> 0. 05)。结论:舒芬太尼复合罗哌卡因用于剖宫产蛛网膜下腔阻滞麻醉可明显缩短感觉阻滞和运动阻滞起效时间,同时延长阻滞持续时间,但会增加瘙痒的发生率。Objective To systematically evaluate the effectiveness of combination of ropivacaine with sufentanil or ropivacaine alone for spinal anesthesia. Method We systematically searched for randomized controlled trials( RCTs) involving comparisons of combinations of ropivacaine with sufentanil( experimental group) with ropivacaine alone( control group) in spinal anesthesia for cesarean section in Wan Fang Data、CNKI、VIP、Pub Med、Embase and The Cochrane Library. Quality evaluation and data extraction was conducted for the included literatures. Meta-analysis were performed using Rev Man 5. 3 software. Results Ten RCTs involving 856 patients were included. Results of meta-analysis showed that:(1)Main outcome indicators: The onset time of sensory block[SMD =-1. 01,95% CI(-1. 63,-0. 40),P < 0. 05]and motor entirely block[SMD =-0. 47,95% CI(-0. 75,-0. 18),P < 0. 05] were shorter in experimental group; The time of sensory[SMD = 1. 13,95% CI( 0. 51,1. 74),P < 0. 05]and motor[SMD = 0. 51,95% CI( 0. 11,0. 91),P < 0. 05] recovery were longer in experimental group;(2)Secondary outcome indicator: The incidence of pruritus was increased in experimental group[SMD = 13. 27,95% CI( 6. 21,28. 33),P < 0. 05]; There was no statistical differences between experimental and control groups in nausea and vomiting( P > 0. 05). Conclusion Combination of ropivacaine with sufentanil may shorten the onset time of sensory and motor block and lengthen the duration of block in spinal anesthesia for the cesarean section,but it also increases the incidence of pruritus.

关 键 词：舒芬太尼 罗哌卡因 剖宫产 蛛网膜下腔阻滞麻醉 META分析 

分 类 号：R614[医药卫生—麻醉学]