七氟醚或异丙酚复合麻醉诱导效应和不良事件发生的比较:Meta分析

目的 采用Meta分析法比较麻醉诱导时七氟醚复合麻醉与异丙酚复合麻醉诱导效应和不良事件的发生.方法 检索Cochrane图书馆、PubMed、OVID、EMBASE和CBM等的数据库,分别收集非心脏手术患者应用七氟醚或异丙酚复合麻醉诱导的前瞻性临床随机对照研究.采用Cochrane协作网系统评价法评价纳入文献的质量.收集两组患者资料采用RevMan 4.2.8软件进行Meta分析.结果 共纳入13项研究,包括968例患者.分为七氟醚复合麻醉组(S组)和异丙酚复合麻醉组(P组).与P组比较,S组意识消失时间和麻醉诱导时间延长,呼吸抑制发生率降低,喉罩置入期不良事件发生率降低(P＜0.05),麻醉诱导期不良事件发生率和喉罩首次置入成功率差异无统计学意义(P＞0.05).结论 异丙酚复合麻醉适用于快诱导麻醉,七氟醚复合麻醉适用于慢诱导麻醉,且七氟醚复合麻醉较异丙酚复合麻醉不良事件发生机率低,对拟采用喉罩通气的患者更安全.

Efficacy and adverse events of sevoflurane versus propofol combined anesthesia for induction of general anesthesia: a Meta-analysis

Objective To systematically review the efficacy and adverse events of sevoflurane or propofol combined anesthesia for induction of general anesthesia. Methods We searched the PubMed, OVID, EMBASE,Cochrane Library and Chinese Biomedical Database (CBM) for studies on efficacy of sevoflurane versus propofol for anesthesia induction. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 4.2.8 software. Results Thirteen prospective randomized controlled trials involving 968 patients were included in our meta-analysis. The results showed that the time from onset of induction to loss of consciousness and the time for induction were significantly longer, the incidence of respiratory depression lower in S group than in P group. There were no significant differences in the incidence of adverse events during induction and success rate of inserting LMA at first attempt between the 2 groups. The incidence of adverse events with LMA insertion was significantly lower in S group than in P group. Conclusion Propofol combined anesthesia is suitable for rapid induction of anesthesia, and sevoflurane combined anesthesia is indicated for slow induction of anesthesia in patients with potential respiratory difficulty and for LMA insertion.