比较右美托咪定与曲马多预防围术期寒战效果的Meta分析

目的：分析右美托咪定与曲马多预防围术期寒战的效果以及不良反应发生情况。方法：检索万方数据库、中国知网等中文数据库及Pubmed、Medline等外文数据库，收集2010年1月至2014年6月有关右美托咪定与曲马多预防围术期寒战效果比较的临床随机对照试验。根据Cochrane系统评价手册5.0对纳入研究的文献进行质量评价。在RevMan5.1软件中对相应的研究指标进行Meta分析。结果：有14篇文献进入了本次Meta分析，共854例患者。疗效方面：右美托咪定预防围术期寒战的效果均显著优于曲马多（RR=0.60，95%CI：0.41～0.88，P=0.008)。不良反应方面：右美托咪定组恶心、呕吐的发生率显著低于曲马多组（RR=0.07，95%CI：0.03～0.14，P＜0.00001），头晕发生率显著低于曲马多组（RR=0.28，95%CI：0.11～0.73，P=0.01）。漏斗图表明各项指标未有显著性发表偏倚。结论：右美托咪定预防围术期寒战的效果优于曲马多，恶心、呕吐等不良反应的发生率较曲马多明显降低。

A Meta-analysis of dexmedetomidine versus tramadol in prevention of perioperative shivering

Objective: To compare the effects of dexmedetomidine and tramadol in prevention of perioperative shivering and evaluate their side effects. Methods: All the randomized controlled trials referring to the comparison of dexmedetomidine and tramadol in prevention of perioperative shivering were searched in the domestic and foreign databases in recent five years. The enrolled published literatures were analyzed using Meta-analysis method with RevMan5.1 statistical analysis software. Results: Fourteen separate clinical randomized controlled trials including 854 cases were researched with the Meta-analysis. Objective responsiveness: the perioperative shivering rates of dexmedetomidine group were less than that of tramadol group (P=0.008). The RR values and 95%CI (confidence interval) were 0.60 (0.41~0.88). Adverse reactions: the incidence of nauses and vomiting were lower in the dexmedetomidine group than that in the tramadol group (P=0.008), the RR and 95%CI were 0.07 (0.03~0.14). The incidence of dizziness were lower in the dexmedetomidine group than that in the tramadol group (P=0.01), the RR and 95%CI were 0.28 (0.11~0.73). The funnel plots showed no significant publication bias in each indexes. Conclusion: The roles of prevention of perioperative shivering in dexmedetomidine group are superior to tramadol group. The incidence of adverse reactions are less in the dexmedetomidine group than that in the tramadol group.