囚右旋美托咪碇用于椎管内麻醉随机对照试验的Meta分析下^^:500VF月K谏区学枠2011.11(12}:1419-1426论著•二次研究右旋美托咪唳用于椎管内麻醉随机对照试验的Meta分析赵博马虹・中阳阪科大学附確第■・阪am肿科(沈用HOOOI)摘更目的系址评价右匕英托咪虹川：win内扈酣的勺效性和农仝性方法计◎机检纟MbM认EBSCO.Springer.Ovid.CNKI和万方数堀叭并制以『丁和机检含找相关文献的參书文献.金找右旋吏托味烷用F椎奋内麻酔的验机对頼试毀(RCT).丈献檢点起止财间均从建片亍2011耶2J1在按纳人与揩陈标准进行资料扯取和文献质*评价后.采川RCVMM5・0软件进行Mg分析结果纳入门个RCT•共计672洌患箔Meta分析结果显示:与生理盐水相比.右範羌托咪航能明显管内麻醉!B觉达刘T10的平均时间IWMD—239.95%CI(-4.40.-0.39)|和运动闭滞达刘Bronugc3的平均时间［WMD・-5.30,95%CI(-7.18,-3.4311.并肚氏总觉阳滞消iU两个节段的f均时间WMD=5I.14,95%CI(44.96.5732)］和込动阳滿消迟令Bronugc0的Y均时同IWMD=68.46,95%CI(58.56.98.35)L同时明显冷恫心动过缓发生申RA3.O3.95%CI(1.61•5.59)•］减少察战发IRR=0.47.95%CI(0.28,0.80)1;但在徵曲压以及术后恐心咆叶的发生牢方面两者差曰尤统计学您义结论现飞明.右視关托味*可明显剜a惟#内麻册的附滞乜效时间打时间■同时可以悔低喪半.但也会朗昴冷加心动过缓的发牛半)关健词右旋关托嗦唱椎骨内麻陪糸统评价;Meta分析；随眦対照试验参考文献/REFERENCESICarolloDS,NossamanBD,RamadhyaniU.Dexmedetomidine:areviewofclinicalapplications.CurrOpinAnaesthesiol,2008,21(4):457-461.2郝静，马正良.a2受休激动剂在围术期中的应用进展.国际麻醉学与复苏杂志，2010,31(3):266-269.3KonakciS,AdanirT,YilmazG,etal.Theefficacyandneurotoxicityofdexmedetomidineadministeredviatheepiduralroute.EurJAnaesthesiol,2008,25(5):403-409.4黄希照，余守章，许学兵，等.勒内注射右旋美托咪喘对大鼠罗哌卡因蛛网膜下腔阻滞效杲的影响.中华麻醉学,2009,29(7):621-625.5MagalhaesE,LadeiraLC,GoveiaCS,etal.Intravenousdexmedetomidineforsedationdoesnotinterferewithsensoryandmotorblockdurationduringspinalanesthesia・RevBrasAnestesiol,2006,56(1):1-7.6El-HennawyAM,Abd-ElwahabAM,Abd-ElmaksoudAM,etal.Additionofclonidineordexmedetomidinetobupivacaineprolongscaudalanalgesiainchildren.BrJAnaesth,2009,103(2):268-274.7Kuzucuo?luT,Bdlukba??o?luI,ArslanG,etal•Comparisonoftheactivityandreliabilityofintravenousadministrationofmidazolamanddexmedetomidineonsedationlevelsunderepiduralanesthesia.A?RI,2010,22(3):121-130.8McVeyJD,TobiasJD.Dexmedetomidineandketamineforsedationduringspinalanesthesiainchildren.JClinAnesth,2010,22(7):538-545..9TalkeP,TongC,LeeHW,etal•Effectofdexmedetomidineonlumbarcerebrospinalfluidpressureinhumans.AnesthAnalg,1997,85(2):358-364.10SaadawyI，BokerA,ElshahawyMA,etal.Effectofdexmedetomidineonthecharacteristicsofbupivacaineinacaudalblockinpediatrics・ActaAnaesthesiolScand,2009,53(2):251・256・IIElhakimM,AbdelhamidD,AbdelfattachH,etal.Effectofepiduraldexmedetomidineonintraoperativeawarenessandpost-operativepainafterone-lungventilation.ActaAnaesthesiolScand,2010,54(6):703-709.12SchnaiderTB,VieiraAM,BrandKoAC,etal•Intraoperativeanalgesiceffectofepiduralketamine,clonidineordexmedetomidineforupperabdominalsurgery.RevBrasAnestesiol,2005,55(5):525・531・13赵若光.右美托咪定用于腰硬联合麻醉病人术中镇静的临床观察.福建医药杂志,2010,32(6):30-32.14KunisawaT,HanadaS,KurosawaA,etal•Dexmedetomidinewassafelyusedforsedationduringspinalanesthesiainaveryelderlypatient.JAnesth,2010,24(6):938-941.15VieiraAM,SchnaiderTB,BrandKoAC,etal•Epiduralclonidineordexmedetomidineforpost-cholecystectomyanalgesiaandsedation.RevBrasAnestesiol,2004,...