靶控静脉输注依托咪酯对手术患者血流动力学波动的meta分析

目的 系统评价在靶控输注下依托咪酯对手术患者血流动力学波动的影响.方法 应用计算机检索Embase、Cochrane、PubMed、万方、知网、维普等数据库,检索时间均从建库至2016年9月,按纳入标准和排除标准对文献进行资料提取以及质量评价,对符合标准的随机对照试验(RCT)应用RevMan 5.2软件进行循证医学分析.结果 在提取文献后总共纳入8个随机对照试验,总计纳入患者458例.循证医学结果:依托咪酯组和异丙酚组相比较,患者在插管后5 min心率、舒张压波动差异具有统计学意义(P<0.05),收缩压波动差异无统计学意义(P>0.05);患者在手术开始切皮时心率变化差异有统计学意义(P<0.05),收缩压、舒张压波动差异无统计学意义(P>0.05);患者在手术结束后心率、收缩压、舒张压波动差异无统计学意义(P>0.05).结论 应用依托咪酯靶控输注对患者的麻醉诱导及维持过程中具有良好的稳定的血流动力学.

Effect of etomidate by target-controlled infusion on the hemodynamics of patients: a meta-analysis

Objective To evaluate the effect of etomidate by target-controlled infusion on the hemodynamics of surgical patients. Methods Embase, Cochrane, PubMed, CECDB, CNKI, CQVIP databases were searched from in-ception to September 2016 for randomized controlled trials. The included studies were evaluated and the extracted data were analyzed by RevMan 5.2. Results Eight randomized controlled trials, with a total of 458 patients, were included. When compared with the propofol group, the heart rate (HR) and diastolic blood pressure (DBP) in the etomidate group were significantly higher after 5 min of intubation (P<0.05), while systolic blood pressure (SBP) showed no significant differences (P>0.05). At the time of doing surgery, the HR in the etomidate group was significantly higher (P<0.05), but SBP and DBP showed no significant difference (P>0.05). After the operation finished, the HR, SBP, DBP all showed no significant difference (P>0.05). Conclusion Etomidate by target-controlled infusion has a good hemodynamic stability for anesthesia induction and maintenance.