盐酸昂丹司琼注射液预防剖宫产患者麻醉后非恶心呕吐不良反应效果的系统评价

目的:基于荟萃分析(Meta分析)方法,系统评价盐酸昂丹司琼注射液对剖宫产患者麻醉后瘙痒、寒战、低血压及心动过缓等不良反应的影响。方法:计算机检索中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、中文科技期刊数据库、万方数据库、PubMed及the Cochrane Library,检索时间从建库至2019年6月。收集在剖宫产手术中使用盐酸昂丹司琼注射液的随机对照试验(干预组患者使用盐酸昂丹司琼注射液,对照组患者使用等量0.9%氯化钠注射液)。采用Rev Man 5.3软件对收集的文献进行Meta分析。结果:共纳入23篇文献,涉及2 008例患者,其中干预组患者1 003例,对照组患者1 005例。Meta分析结果显示,干预组剖宫产患者麻醉后瘙痒、寒战、低血压及心动过缓等不良反应的发生率均显著低于对照组,差异均有统计学意义(P<0.05)。干预组围术期使用麻黄碱的患者数明显少于对照组,差异有统计学意义(P<0.05);与对照组比较,干预组胎儿娩出时的脐动脉血p H更接近正常范围,差异有统计学意义(P<0.05)。两组患者围术期麻黄碱使用剂量、新生儿娩出5 min后Apgar评分比较,差异均无统计学意义(P>0.05)。结论:盐酸昂丹司琼注射液能降低剖宫产患者椎管内麻醉后瘙痒、寒战、低血压及心动过缓的发生率,减少麻黄碱的使用。

Systematic Review of Effects of Ondansetron Hydrochloride Injection in Preventing Non-Nausea and Vomiting Adverse Drug Reactions After Cesarean Section

OBJECTIVE: To systematically evaluate the effects of ondansetron hydrochloride injection on adverse drug reactions such as pruritus,shivering,hypotension and bradycardia in patients with cesarean section after anesthesia based on Meta-analysis. METHODS: CBM,CNKI,VIP database,Wanfang database,PubMed and the Cochrane Library were retrieved to collect the randomized controlled trials of ondansetron hydrochloride injection used during cesarean section( the intervention group was treated with ondansetron hydrochloride injection,while the control group received the equivalent amount of 0. 9% sodium chloride injection).The retrieval time was from the establishment of the database to Jun. 2019. Meta-analysis was performed by using RevMan 5. 3 software. RESULTS: A total of 23 literature were included,and 2 008 patients were enrolled,including 1 003 patients in the intervention group and 1005 patients in the control group.Meta-analysis results showed that the incidence of pruritus,shivering,hypotension,bradycardia and other adverse drug reactions in patients with cesarean section in the intervention group was significantly lower than that in the control group,with statistically significant difference( P < 0. 05). The number of patients with ephedrine during the perioperative period in the intervention group was significantly less than that in the control group,and the difference was statistically significant( P < 0. 05). Compared with the control group,the pH of the umbilical artery blood at time of delivery of the fetus in the intervention group was closer to the normal range,and the difference was statistically significant( P < 0. 05). There was no significant difference between two groups in the perioperative dosage of ephedrine and Apgar score after delivery of 5 minutes( P > 0. 05). CONCLUSIONS: Ondansetron hydrochloride injection can decrease the incidence of pruritus,shivering,hypotension and bradycardia after spinal anesthesia in patients with cesarean section,and reduce the use of ephedrine.