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咪达唑仑与右美托咪啶对照研究的回顾性分析 被引量:2

Retrospective report for the controlled trials of dexmedetomidine versus midazolam
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摘要 目的:收集2009~2015年发表的有关右美托咪啶与咪达唑仑之间随机对照研究进行分析,进一步验证右美托咪啶与咪达唑仑的镇静效果及对机械通气时间、ICU住院时间等的影响。方法:主要对PubMedmedline、ovid-embase、Cochrane Library进行检索,纳入标准为针对ICU成人患者使用右美托咪啶与咪达唑仑镇静治疗的随机对照试验。运用Review Manager 5.0软件进行统计分析,连续性变量采用加权均数差WMD及其95%CI表示,二分类变量资料采用相对危险度RR及其95%CI表示,率的比较采用方差倒数分析。结果:镇静目标达标时间百分比比较差异无统计学意义(WMD=0.03,95%CI:-0.01~0.07,P=0.1);右美托咪啶组能缩短机械通气时间(WMD=-32.35,95%CI:-46.41^-18.29,P<0.05);ICU住院时间更短(WMD=-40.82,95%CI:-43.10^-38.54,P<0.05);心动过缓发生率更高(RR=2.49,95%CI:1.79~3.46,P<0.05);低血压发生率比较差异无统计学意义(RR=1.20,95%CI:0.73~1.95,P=0.48)。结论:右美托咪啶能产生与咪达唑仑相同的镇静效果,同时缩短机械通气时间及ICU住院时间,但其产生心动过缓的不良反应也应予以关注。 Objective:Analyze the randomized-controlled trials of dexmedetomidine versus midazolam that published between 2009 to 2015.And validate the two sedatives' efficacy,and the impact to duration of mechanical ventilation and length of ICU stay.Method:Studies were independently searched in Pubmed-medline、ovid-embase、and cochrane library.The randomized-controlled trials of dexmedetomidine versus midazolam were selected.Analysis was performed with Review Manager version 5.3.Continuous outcomes were demonstrated by the style of weight mean difference(WMD)with 95% confidence interval(CI).Then dichotomous outcomes were demonstrated by the style of risk ratio(RR)with 95%CI.Rate outcomes were demonstrated by the style of generic inverse variance.Result:There was no difference in percentage of time within the sedation target [WMD =0.03,95%CI(-0.01,0.07),P=0.1].In dexmedetomidine-treated patients,duration of mechanical ventilation was shorter[WMD=-32.35,95%CI(-46.41,-18.29),P〈0.05],the same as length of ICU stay[WMD=-40.82,95%CI(-43.10,-38.54),P〈0.05].But there was higher incidence of bradycardia [RR=2.49,95%CI(1.79,3.46),P〈0.05]while no difference in incidence of hypotension[RR=1.20,95%CI(0.73,1.95),P=0.48].Conclusion:Dexmedetomidine has the similar efficacy versus midazolam,while shorten duration of mechanical ventilation and length of ICU stay.The adverse reaction such as bradycardia should also be paid attention to.
出处 《临床急诊杂志》 CAS 2016年第2期124-127,共4页 Journal of Clinical Emergency
关键词 右美托咪啶 咪达唑仑 随机对照研究 dexmedetomidine midazolam randomized-controlled trials
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参考文献11

  • 1Mehta S, McCullagh I, Burry L. Current sedation tices: lessonslearned frominternational surveys prac- [J]. Anesthesiol Clin, 2011,29 (4) : 607 - 624.
  • 2Aitken L M, Bucknall T, Kent B, et al. Protocol-direct- edsedationversusnon-protocol-directedsedation to re- duceduration of mechanicalventilation in mechanically- ventilatedintensivecarepatients[J]. Cochrane Database Syst Rev, 2015,1 : CD009771.
  • 3汤文喜,刘金山,董传珍,宋光明,孙运波.丙泊酚、咪达唑仑靶控输注和脑电双频指数监测用于ICU患者镇静的临床研究[J].临床急诊杂志,2008,9(4):220-224. 被引量:8
  • 4Barr J,Fraser G L,Puntillo K, et al. Clinical practice guidelines for the management of pairi, agitation, and delirium in adult patients in the intensive care unit[J]. Crit Care Med,2013,41(1) :263-306.
  • 5Riker R R, Shehabi Y,Bokesch P M, et al. Dexmedeto- midine vs midazolam for sedation of critically Ill pa-tients A randomized trial[J]. JAMA, 2009,301 (5) : 489-499.
  • 6Senoglu N, Oksuz H,Dogan Z. et al. Sedation during noninvasive mechanical ventilation with dexmedetomi- dine or midazolam: A randomized, double-blind, pro- spective study[J]. Curt Ther Res Clin Exp, 2010,71 (3):141-153.
  • 7Jakob S M,Ruokonen E,Grounds R M. et al. Dexme- detomidine vs midazolam or propofol for sedation dur- ing prolonged mechanical ventilation: two randomized controlled trials[J]. JAMA, 2012,307 (11) : 1151 - 1160.
  • 8Huang Z,Chen Y S, Yang Z L, et al. Dexmedetomidine versus midazolam for the sedation of patients with non-invasive ventilation failure[J]. Intern Med, 2012, 51(17) :2299-2305.
  • 9Gupta S, Singh D, Sood D. et al. Role of dexmedetomi- dine in early extubation of the intensive care unit pa- tients[J]. J AnaesthesiolClinPharmacol, 2015,31 ( 1 ) : 92-98.
  • 10Gerlach A T, Dasta J F. Dexmedetomidine: an up-dated review[J]. Ann Pharmacother, 2007, 41 (2): 245 - 254.

二级参考文献7

  • 1曹铭辉,梁建军,纪风涛,叶西就,杨勇志,吴强,苗利萍.丙泊酚靶控输注在外科ICU病人清醒镇静中的应用[J].临床麻醉学杂志,2005,21(9):628-630. 被引量:7
  • 2VAN DEN NIEUWEAHUYZEN MC ,ENGBERS FH, VUYK J, et al. Target -controlled infusion systems: role in anaesthesia and anaIgesia[J]. Clin Pharmacokinet ,2000,38 (2) : 181.
  • 3KENNY GN. Patient sedation: technical problems and developments [ J ]. Eur J Anaesthesiol ( Suppl), 1996,13 : 18.
  • 4SESSLER CN,GOSNELL MS,GRAP MJ,et al. The richmond agitation - sedation scale validity and reliability in adult intensive care unit patients[ J ]. Am J Respir Crit Care Med,2002,166 (10) : 1338.
  • 5MILLER LJ,WILES-PFEIFLER R. Propofol for the long -term sedation of a critically ill patient[ J ]. Am J Crit Care, 1998,7 (1) : 73.
  • 6KANTO JH. Midazolam : The first water - soluble benzodiazepine. Pharmacology, pharmacokinetics, and efficacy in insomnia and anesthesia[ J]. Pharmacotherapy, 1985,5 : 138.
  • 7MCMURRAY TJ,JOHNSTON JR, MILLIGAN KR,et al. Propofol sedation using Diprifusor target - controlled infusion in adult intensive care unit patients [ J ]. Anaesthesia,2004,59 ( 7 ) : 636.

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