右美托咪定与几种镇静药物在口腔门诊手术中镇静效果的meta分析

doi:10.19438/j.sjos.2019.01.021

摘要/Abstract

摘要： 目的:采用meta分析,比较右美托咪定与咪达唑仑、氯胺酮和安慰剂在口腔门诊手术中的镇静效果。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science,检索时间从建库至2017年10月。收集口腔门诊手术中比较右美托咪定与咪达唑仑、氯胺酮或安慰剂镇静效果的随机对照试验（RCT）。采用Cochrane协作网系统评价法评价纳入文献质量,采用RevMan5.3软件对收集的患者资料进行meta分析。结果:共纳入12篇RCT、678例患者。Meta分析结果显示,右美托咪定组儿童的镇静评分低于生理盐水组(SMD=-1.73,95%CI:-2.70~-0.77,P=0.0004);右美托咪定组成人的镇静评分也低于生理盐水组(SMD=-2.23,95%CI:-4.39~-0.08,P=0.04);右美托咪定组儿童的镇静满意度与氯胺酮组无显著差异（RR=1.14,95%CI：1.00~1.30,P=0.05）;右美托咪定组儿童的镇静满意度优于咪达唑仑组（RR=1.38,95%CI：1.15~1.67,P=0.0006）;右美托咪定组成人的镇静满意度与咪达唑仑组无显著差异（RR=1.42,95%CI：0.86~2.33,P=0.17）;并且右美托咪定组儿童的行为满意度优于氯胺酮组（RR=1.19,95%CI：1.03~1.36,P=0.01）,也优于咪达唑仑组（RR=1.28,95%CI：1.07~1.54,P=0.008）。结论:与其他镇静药物相比,右美托咪定用于口腔门诊手术适度镇静可能是一种更好的选择。

关键词: 右美托咪定, 镇静, 口腔手术, Meta分析

Abstract: PURPOSE: To evaluate the efficacy of dexmedetomidine and midazolam, ketamine or placebo administrated in outpatient dental surgery. METHODS: PubMed, Embase, Cochrane Library and Web of Science were searched from inception to October 2017,to find all randomized controlled trials(RCTs) about the sedative effect of dexmedetomidine versus midazolam, ketamine or placebo during outpatient dental surgery. The quality of the studies was evaluated by the method recommended by Cochrane collaboration. Meta analysis was conducted using Review Manager 5.3 software. RESULTS: Twelve clinical trials with 678 patients were included. The results of meta analysis showed that the sedation score of children was lower in group of dexmedetomidine than that of group of normal saline (SMD=-1.73,95%CI:-2.70~-0.77,P=0.0004) and the sedation score of adults was also lower in group of dexmedetomidine than that of group of normal saline(SMD=-2.23,95%CI:-4.39~-0.08,P=0.04).There was no significant difference in sedation satisfaction of children between dexmedetomidine and ketamine(RR=1.14,95%CI:1.00-1.30,P=0.05).Dexmedetomidine provided more satisfactory sedation of children than midazolam(RR=1.38,95%CI:1.15-1.67,P=0.0006),and there was no significant difference in sedation satisfaction of adults between dexmedetomidine and midazolam (RR=1.42,95%CI:0.86-2.33,P=0.17). Moreover,dexmedetomidine provided more satisfactory behavior of children than ketamine (RR=1.19,95%CI:1.03-1.36,P=0.01) and midazolam (RR=1.28,95%CI:1.07-1.54,P=0.008). CONCLUSIONS: Compared with other sedative drugs, dexmedetomidine may be a better choice for moderate sedation during outpatient dental surgery.

Key words: Dexmedetomidine, Sedation, Dental surgery, Meta analysis

中图分类号:

R782.05

孟秋雨, 黄慧敏, 徐辉. 右美托咪定与几种镇静药物在口腔门诊手术中镇静效果的meta分析[J]. 上海口腔医学, 2019, 28(1): 100-109.

MENG Qiu-yu, HUANG Hui-min, XU Hui. The sedative effect of dexmedetomidine in outpatient undergoing dental surgery compared to several sedative drugs:a meta analysis[J]. Shanghai Journal of Stomatology, 2019, 28(1): 100-109.

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