国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
2期
138-144
,共7页
目的 系统评价Sugammadex和新斯的明对氨基甾体类肌松药诱导肌肉松弛的拮抗效果和副作用.方法 计算机检索PubMed、EBSCO、Springer、Ovid、Embase、Cochrane Library和CNKI、万方数据库,检索起止时间为从建库至2013年6月.收集Sugammadex和新斯的明用于拮抗肌肉松弛的随机对照试验(randomized controlled trial,RCT),由2位研究者对纳入研究进行资料提取和质量评价后,采用RevMan5.2软件进行Meta分析.结果 纳入6个RCT,包括533例患者.Meta分析:无论是中度还是深度神经肌肉阻滞,Sugammadex组四个成串刺激(train-of-four,TOF)值恢复到70％、80％和90％的平均时间明显快于新斯的明组.深度TOF值恢复到70％、80％、90％的平均时间分别为[WMD=-31.37,95％CI(-39.08,-23.66),P＜0.000 01]、[WMD =-39.27,95％CI(-48.48,-30.05),P＜0.000 01]和[WMD=-46.36,95％CI(-56.03,-36.69),P＜0.000 01],中度TOF值恢复到70％、80％、90％的平均时间分别为[WMD=-5.13,95％CI(-7.38,-2.89),P＜0.000 01]、[WMD=-11.65,95％CI(-13.48,-9.82),P＜0.000 01]和[WMD=-18.43,95％CI(-23.80,-13.05),P＜0.000 01].同时Sugammadex组患者发生药物相关副作用的概率小于新斯的明组,其差异有统计学意义[OR=0.54,95％CI(0.35,0.85),P=0.007].结论 在中度和深度神经肌肉阻滞情况下,和新斯的明组比较,Sugammadex组对氨基甾体类肌松药诱导肌肉松弛的拮抗效果更强、安全性更高.
目的 繫統評價Sugammadex和新斯的明對氨基甾體類肌鬆藥誘導肌肉鬆弛的拮抗效果和副作用.方法 計算機檢索PubMed、EBSCO、Springer、Ovid、Embase、Cochrane Library和CNKI、萬方數據庫,檢索起止時間為從建庫至2013年6月.收集Sugammadex和新斯的明用于拮抗肌肉鬆弛的隨機對照試驗(randomized controlled trial,RCT),由2位研究者對納入研究進行資料提取和質量評價後,採用RevMan5.2軟件進行Meta分析.結果 納入6箇RCT,包括533例患者.Meta分析:無論是中度還是深度神經肌肉阻滯,Sugammadex組四箇成串刺激(train-of-four,TOF)值恢複到70％、80％和90％的平均時間明顯快于新斯的明組.深度TOF值恢複到70％、80％、90％的平均時間分彆為[WMD=-31.37,95％CI(-39.08,-23.66),P＜0.000 01]、[WMD =-39.27,95％CI(-48.48,-30.05),P＜0.000 01]和[WMD=-46.36,95％CI(-56.03,-36.69),P＜0.000 01],中度TOF值恢複到70％、80％、90％的平均時間分彆為[WMD=-5.13,95％CI(-7.38,-2.89),P＜0.000 01]、[WMD=-11.65,95％CI(-13.48,-9.82),P＜0.000 01]和[WMD=-18.43,95％CI(-23.80,-13.05),P＜0.000 01].同時Sugammadex組患者髮生藥物相關副作用的概率小于新斯的明組,其差異有統計學意義[OR=0.54,95％CI(0.35,0.85),P=0.007].結論 在中度和深度神經肌肉阻滯情況下,和新斯的明組比較,Sugammadex組對氨基甾體類肌鬆藥誘導肌肉鬆弛的拮抗效果更彊、安全性更高.
목적 계통평개Sugammadex화신사적명대안기치체류기송약유도기육송이적길항효과화부작용.방법 계산궤검색PubMed、EBSCO、Springer、Ovid、Embase、Cochrane Library화CNKI、만방수거고,검색기지시간위종건고지2013년6월.수집Sugammadex화신사적명용우길항기육송이적수궤대조시험(randomized controlled trial,RCT),유2위연구자대납입연구진행자료제취화질량평개후,채용RevMan5.2연건진행Meta분석.결과 납입6개RCT,포괄533례환자.Meta분석:무론시중도환시심도신경기육조체,Sugammadex조사개성천자격(train-of-four,TOF)치회복도70％、80％화90％적평균시간명현쾌우신사적명조.심도TOF치회복도70％、80％、90％적평균시간분별위[WMD=-31.37,95％CI(-39.08,-23.66),P＜0.000 01]、[WMD =-39.27,95％CI(-48.48,-30.05),P＜0.000 01]화[WMD=-46.36,95％CI(-56.03,-36.69),P＜0.000 01],중도TOF치회복도70％、80％、90％적평균시간분별위[WMD=-5.13,95％CI(-7.38,-2.89),P＜0.000 01]、[WMD=-11.65,95％CI(-13.48,-9.82),P＜0.000 01]화[WMD=-18.43,95％CI(-23.80,-13.05),P＜0.000 01].동시Sugammadex조환자발생약물상관부작용적개솔소우신사적명조,기차이유통계학의의[OR=0.54,95％CI(0.35,0.85),P=0.007].결론 재중도화심도신경기육조체정황하,화신사적명조비교,Sugammadex조대안기치체류기송약유도기육송이적길항효과경강、안전성경고.
Objective To do systematic review of the efficacy and adverse effect of sugammadex versus neostigmine on reversal of neuromuscular block induced by amino-steroidal muscle relaxants.Methods The relevant randomized controlled trials (RCTs) were searched in PubMed,EBSCO,Springer,Ovid,Embase,Cochrane Library,CNKI and WanFang Data from the date of their establishment to June 2013.The data were extracted and the quality of the included studies was evaluated by two reviewers independently.Then the Meta-analysis was performed with RevMan 5.2 software.Results Six RCTs involving 533 cases were included.Compared to neostigmine,the mean time to recovery of the train-of-four (TOF) ratio to 0.7,0.8 and 0.9 were significantly shorter in sugammadex cases,regardless of moderate or deep neuromuscular blockade.The mean time to recovery of the TOF ratio to 0.7,0.8 and 0.9 under deep neuromuscular blockade were [WMD=-31.37,95％CI(-39.08,-23.66),P＜0.000 01],[WMD=-39.27,95％CI(-48.48,-30.05),P＜0.000 01] and [WMD=-46.36,95％CI(-56.03,-36.69),P＜0.000 01],respectively.The mean time to recovery of the TOF ratio to 0.7,0.8 and 0.9 under moderate neuromuscular blockade were [WMD=-5.13,95％CI (-7.38,-2.89),P＜0.000 01],[WMD=-1 1.65,95％CI(-13.48,-9.82),P＜0.000 01] and [WMD=-18.43,95％CI(23.80,-13.05),P＜0.000 01],respectively.Compared to neostigmine group,the percentage of patients with drug-related adverse effect was decreased [OR=0.54,95％CI (0.35,0.85),P=0.007] in sugammadex group.Conclusions Both in moderate and deep neuromuscular blockade,the efficacy of sugammadex on reversal of amino-steroidal muscle relaxants induced neuromuscular block was much stronger and safer than that of neostigmine.
