静脉注射右美托咪定或可乐定治疗腰麻后寒战的比较：meta分析

2020

07/14

米勒之声

A-

A+

右美托咪定和可乐定在治疗寒战的药物中研究最为广泛，因为α2肾上腺素能激动剂可以降低寒战阈值。本研究的目的是比较右美托咪定和可乐定用于控制腰麻后寒战的疗效及并发症情况。

背景与目的

方法

检索相关数据库，并搜集比较了右美托咪定和可乐定治疗腰麻后寒战的随机对照试验(RCT)。观察指标为寒战治疗有效率、寒战停止时间、寒战复发率及相关并发症。

结果

本研究共收集了6项试验，纳入340名成年患者。与可乐定相比，右美托咪定治疗寒战的有效率较高(OR 4.11, 95% CI [1.53, 11.07], P=0.005)，寒战持续时间较短(MD= -1.91；95%CI [-3.66，-0.15], P= 0.03)，寒战复发率较低(OR = 0.30；95%CI[0.12，0.75], P= 0.01)。右美托咪定的低血压发生率低于可乐定，镇静效果强于可乐定。

结论

与可乐定相比，右美托咪定治疗腰麻后寒战的效果更好，其有效率更高，镇静效果更好，寒战控制较快，寒战复发率和低血压发生率较低。

原始文献来源及摘要

Wang N, Wang Z, Song X, et al. Intravenous dexmedetomidine versus intravenous clonidine for post spinal anesthesia shivering: a meta-analysis of randomized controlled trials.[J].Scott Med J.2020,0(0):1-9.

Abstract

BACKGROUND: Dexmedetomidine and clonidine are the most extensively studied drugs for shivering treatment, because α2-adrenergic agonists can reduce the shivering threshold. The objective of this meta-analysis was to compare the efficacy and complications of dexmedetomidine with those of clonidine, when used for control of post spinal anesthesia shivering.

METHODS: Electronic databases were searched for randomized controlled trials (RCT) comparing the effect of dexmedetomidine versus clonidine for control of post spinal anesthesia shivering. The endpoints were effective rate of shivering treatment, time to cease shivering, recurrent rate of shivering and complications.

RESULTS: Six studies comprising 340 adult patients were included in this meta-analysis. Dexmedetomidine had higher effective rate of shivering treatment (odds ratio [OR]: 4.11, 95% confidence interval (CI): [1.53, 11.07], P= 0.005), shorter time to cease shivering (Mean differences (MD)=-1.91; 95% CI [-3.66, -0.15], P= 0.03), lower recurrent rate of shivering (OR = 0.30; 95% CI [0.12, 0.75], P= 0.01), compared to clonidine. Dexmedetomidine had a lower rate of hypotension and higher incidence of sedation than clonidine.

CONCLUSIONS: Dexmedetomidine is superior to clonidine when used for shivering treatment after spinal anesthesia, because of higher incidence of effective rate and sedation, faster control of shivering, lower incidence of recurrent rate and hypotention.