全凭静脉麻醉维持期BIS指导下丙泊酚闭环与开环靶控输注效果比较的Meta分析

发布时间：2018-02-22 08:23

本文关键词： 全凭静脉麻醉全身麻醉丙泊酚靶控输注开环闭环脑电双频谱指数 Meta分析　出处：《山东医药》2017年20期 　论文类型：期刊论文

【摘要】：目的系统评价全凭静脉麻醉维持期脑电双频谱指数(BIS)指导下丙泊酚闭环靶控输注(TCI)和开环TCI的效果。方法检索Pubmed、Web of Science、EMBASE、Cochrane图书馆、CNKI、VIP、万方和中国优秀博硕士学位论文全文数据库,纳入BIS指导下丙泊酚闭环TCI对比开环TCI在全凭静脉麻醉中应用的临床随机对照研究。采用Cochranne协作网系统评价法评价纳入文献的质量,采用Revman5.0软件对纳入文献的数据进行Meta分析。结果纳入6篇研究共680例患者,其中闭环TCI 341例(闭环组),开环TCI 339例(开环组)。闭环组充分麻醉时间占麻醉总时间的百分比高于开环组(WMD=12.68,95%CI为7.92~17.43,P0.01),浅麻醉持续时间占麻醉总时间的百分比低于开环组(WMD=-1.38,95%CI为-2.24~-0.51,P0.01),深麻醉持续时间占麻醉总时间的百分比低于开环组(WMD=-9.80,95%CI为-18.51~-1.09,P0.05);麻醉维持期丙泊酚用量明显少于开环组(WMD=-0.28,95%CI为-0.53~-0.03,P0.05)。两组术中体动反应发生率比较差异无统计学意义(RR=0.98,95%CI为0.58~1.68,P=0.95),术后拔管时间比较差异无统计学意义(WMD=-1.36,95%CI为-2.69~-0.02,P=0.05)。结论全凭静脉麻醉维持期闭环TCI对麻醉深度的控制好于开环TCI,且可减少药物用量。
[Abstract]:Objective to systematically evaluate the efficacy of closed loop target-controlled infusion of propofol (TCI) and open-loop TCI under the guidance of bispectral index (BIS) in the maintenance period of total intravenous anesthesia. Under the guidance of BIS, propofol closed loop TCI was compared with open loop TCI in clinical randomized controlled study of total intravenous anesthesia. The quality of literature was evaluated by Cochranne cooperative network system evaluation method. Revman5.0 software was used to analyze the data collected in the literature by Meta. Results 680 patients were included in 6 studies. There were 341 cases of closed loop TCI (closed loop group, open loop TCI 339 cases (open loop group). The percentage of adequate anesthesia time in closed loop group was higher than that in open loop group (CI = 7.92 卤17.43%, P 0.01). The percentage of superficial anesthesia duration in total anesthesia time was lower than that in open loop group. The percentage of duration of deep anesthesia in the total anesthesia time was lower than that in the open loop group (-18.51U -1.09p 0.05CI), and the dosage of propofol in the maintenance period of anesthesia was significantly lower than that in the open ring group (-0.2895CI = -0.53) -0.03P 0.050.There was no significant difference between the two groups in the incidence of somatokinetic reaction. There was no significant difference in extubation time between WMD-1.36 and 95CI (-2.69 ~ -0.02). Conclusion closed loop TCI can control anesthesia depth better than open loop TCI during the maintenance period of total intravenous anesthesia, and can reduce the dosage of drugs.
【作者单位】：河北北方学院;中国人民解放军空军总医院;
【基金】：北京市科技计划项目(Z141100002114010)
【分类号】：R614

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