右美托咪啶与咪达唑仑用于区域麻醉镇静的Meta分析

目的系统评价右美托咪啶与咪达唑仑用于区域麻醉镇静的疗效。方法计算机检索Cochrane Library、Medline、Embase、中国期刊全文数据库、万方数据库、中国生物医学文献数据库（CBM）、中文科技期刊数据库，查找以右美托咪啶与咪达唑仑用于区域麻醉的随机对照试验（RCT），对纳入的RCT进行质量评价，采用RevMan5．1软件进行Meta分析。结果共纳入10项RCT，包括372例患者。Meta分析结果提示，两组在麻醉后15、30分钟以及术后的OAA／S评分、Ramsay评分差异无统计学意义（P〉0．05），而右美托咪啶组麻醉后30分钟的BIS指数以及呼吸抑制的发生率均显著低于咪达唑仑组，心动过缓的发生率高于咪达唑仑组（P〈0．05）。两组低血压以及躁动的发生率差异无统计学意义（P〉0．05），。结论现有的证据表明，右美托咪啶在区域麻醉术中具有较好的镇静效果，并且无呼吸抑制，但是应注意其减慢心率的不良反应。

Meta-analysis of sedative effects of dexmedetomidine and midazolam in regional anesthesia

Objective To meta-analyze the sedative effects of dexmedetomidine（DEX） and midazolam in regional anesthesia. Methods Literatures of randomized controlled trials （RCT） of dexmedetomidine and midazolam in regional anesthesia were searched from Cochrane Library, Medline, Embase, Chinese academic journal database, Wanfang data base, Chinese Biomedical Literature Database （ CBM ） and Chinese scientific journal database. The qualities of RCT were evaluated by using RevMan 5.1 software for Meta-analy- sis. Results A total of 10 RCTs including 372 cases of patients was found. Meta-analysis results showed that the there was no significant difference in Ramsay score and OAA/S score between the two drugs after 15 and 30 minutes of anesthesia. However, BIS index of dexmedetomidine after 30 minutes of anesthesia was lower than that of midazolam. The incidence of respiratory depression of DEX was significantly lower than that of midazolam. No difference of incidence of agitation and hypotension was found between the two drugs. Meanwhile, the incidence of bradycardia of DEX was higher than that of midazolam. Conclusion The available evidences indicate that dexmedetomidine in regional anesthesia surgery has good sedative effect, and no respiratory depression occurs. However, it should pay attention on the adverse reactions of slow heart rate