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目的评价α2受体激动剂是否可以降低七氟烷引起的小儿术后躁动的发生率。方法通过检索Medline、荷兰医学文摘、Cochrane临床试验数据库、中国生物医学文献数据库和中国期刊网全文数据库等数据库,收集可乐定或右美托咪啶对七氟烷引起的小儿术后躁动的预防作用的随机对照试验(randomized controlled trial,RCT),提取资料和评估方法学质量,采用Cochrane协作网RevMan 5.0软件进行Meta分析。结果最终纳入11个RCT,其中104例患儿预防性使用右美托咪啶,268例患儿使用可乐定,365例患儿使用安慰剂。Meta分析显示,可乐定组小儿术后躁动发生率的比值比(OR)为0.31,95%CI为(0.15,0.61)(P=0.000 8);右美托咪啶组小儿术后躁动发生率的OR为0.16,95%CI为(0.08,0.31)(P<0.000 01)。结论α2受体激动剂可以显著降低七氟烷引起的小儿术后躁动的发生率。
Objective To evaluate whether α2 agonists can reduce the incidence of postoperative agitation induced by sevoflurane in children. Methods The preventive effects of clonidine or dexmedetomidine on sevoflurane-induced postoperative agitation in children were collected by searching databases such as Medline, the Netherlands Medical Abstracts, the Cochrane Database, the Chinese Biomedical Literature Database and the Chinese Journal Net Full-text Database Randomized controlled trial (RCT). Data were extracted and methodological quality was assessed. Cochrane Collaboration’s RevMan 5.0 software was used for Meta-analysis. Results Eleven RCTs were eventually enrolled, of whom 104 had prophylactic use of dexmedetomidine, 268 had clonidine, and 365 had had placebo. Meta-analysis showed that the odds ratio (OR) of pediatric post-operative agitation rate in clonidine group was 0.31, and the 95% CI was (0.15, 0.61) (P = 0.0008). The incidence of postoperative agitation in dexmedetomidine group The OR was 0.16 and the 95% CI was (0.08, 0.31) (P <0.000 01). Conclusion α2 agonists can significantly reduce the incidence of postoperative agitation induced by sevoflurane in children.