ABSTRACT
Objective@#To compare the effect of intranasal dexmedetomidine and oral chloral hydrate in deep sedation of children.@*Methods@#The Pubmed, EMBase, CENTRAL (Issue 4, 2018), Web of science, CBM, Wanfang Data, CNKI and VIP databases from the inception to January 2019 were searched. Randomized controlled trials (RCTs) with dexmedetomidine and chloral hydrate as interventions were included and the data were analyzed by RevMam 5.3 and Stata 12.0 software. The success rate of deep sedation, the indicator of sedation onset time, the recovery time, the incidence of vomiting and bradycardia were compared.@*Results@#A total of 7 RCTs involving 1 007 patients were included for analysis. The results showed that the success rate of deep sedation (OR=2.55, 95%CI:1.46-4.44, P<0.01) and the incidence of bradycardia (OR=4.42, 95%CI:1.82-10.74, P<0.01) in the dexmedetomidine nasal group were significantly higher than those in the chloral hydrate oral group. The recovery time was significantly shorter (MD=-16.41, 95%CI:-21.54-11.28, P<0.01) and the incidence rate of vomiting (OR=0.04, 95%CI:0.01-0.17, P<0.01) in dexmedetomidine nasal group was significantly lower than those in the chloral hydrate oral group. There was no significant difference in the indicator of sedation onset time (MD=-0.47, 95%CI:-2.71-1.22, P=0.46).@*Conclusion@#Compared with the traditional oral chloral hydrate, intranasal dexmedetomidine has a higher sedation success rate and shorter recovery time after sedation with a lower incidence of nausea and vomiting.
ABSTRACT
Objective:To compare the effect of intranasal dexmedetomidine and oral chloral hydrate in deep sedation of children.Methods:The Pubmed, EMBase, CENTRAL (Issue 4, 2018), Web of science, CBM, Wanfang Data, CNKI and VIP databases from the inception to January 2019 were searched. Randomized controlled trials (RCTs) with dexmedetomidine and chloral hydrate as interventions were included and the data were analyzed by RevMam 5.3 and Stata 12.0 software. The success rate of deep sedation, the indicator of sedation onset time, the recovery time, the incidence of vomiting and bradycardia were compared.Results:A total of 7 RCTs involving 1 007 patients were included for analysis. The results showed that the success rate of deep sedation ( OR=2.55, 95 %CI:1.46-4.44, P<0.01) and the incidence of bradycardia ( OR=4.42, 95 %CI:1.82-10.74, P<0.01) in the dexmedetomidine nasal group were significantly higher than those in the chloral hydrate oral group. The recovery time was significantly shorter ( MD=-16.41, 95 %CI:-21.54-11.28, P<0.01) and the incidence rate of vomiting ( OR=0.04, 95 %CI:0.01-0.17, P<0.01) in dexmedetomidine nasal group was significantly lower than those in the chloral hydrate oral group. There was no significant difference in the indicator of sedation onset time ( MD=-0.47, 95 %CI:-2.71-1.22, P=0.46). Conclusion:Compared with the traditional oral chloral hydrate, intranasal dexmedetomidine has a higher sedation success rate and shorter recovery time after sedation with a lower incidence of nausea and vomiting.
ABSTRACT
Objective To systematically review the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass.Methods Databases including Pubmed,EMBase,Web of Science,Cochrane Library,CBM,WangFang Data,CNKI and VIP were searched by a computer from the date of database establishment up to February 2019 and there was no limitation for language.The randomized control trials involving the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass were collected.Evaluation indexes included:incidence of perioperative cardiac events,duration of intensive care unit stay,plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening,plasma concentrations of interleukin-6 at 2,12 and 24 h after aortic opening and percentage of spontaneous recovery of heart beat.Meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results Seventeen randomized controlled trials involving 763 patients were included in our meta-analysis.Compared with control group,the incidence of reperfusion arrhythmia was decreased,the plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening and interleukin-6 at 2,12,and 24 h after aortic opening were decreased,the percentage of spontaneous recovery of heart beat was increased (P＜0.05 or 0.01),and no significant change was found in duration of intensive care unit stay in sevoflurane postconditioning group (P ＞ 0.05).Conclusion Sevoflurane postconditioning can produce cardioprotection in the patients undergoing cardiac surgery with cardiopulmonary bypass.
