| 摘要: |
| 目的 评价硬膜外联用新斯的明用于分娩镇痛的有效性和安全性。方法 检索Cochrane 图书馆、PubMed、EMbase、万方数据库、中国知网、中国生物医学文献服务系统,检索时间均从建库到2011年9月,收集硬膜外联用新斯的明用于分娩镇痛与单纯使用局麻药和(或)阿片类药比较的随机对照试验。由2名评价员独立评价文献,对符合入选标准的研究用RevMan 5.1.4软件进行meta分析。对连续变量以均数差(MD)及其95%置信区间(CI)分析统计量；对二分类变量以相对危险度及其95% CI分析统计量。结果 共纳入4篇文献,其中2篇英文,2篇中文,包括282例患者。分析结果 显示:硬膜外联用新斯的明与单纯使用局麻药和(或)阿片类药相比,其产妇疼痛视觉模拟评分较低,差异有统计学意义低剂量组(1~2 μg/kg或250 μg):MD=-1.45,95%CI(-2.84,-0.07),P=0.04;中等剂量组(4 μg/kg或500 μg):MD=-2.35,95%CI(-3.69,-1.02),P=0.000 6;高剂量组(6~7 μg/kg或750 μg):MD=-21,95%CI(-36.31,-5.69),P=0.007 ];而在产程、剖宫产率或器械助产率、产妇恶心呕吐发生率及胎儿Apgar评分等方面,两组差异均无统计学意义。结论 硬膜外联用新斯的明与单纯使用局麻药和(或)阿片类药物相比较,可增强分娩镇痛的效果,并且不增加不良反应发生率。 |
| 关键词: 新斯的明 硬膜外镇痛；产科镇痛；meta分析 |
| DOI：10.3724/SP.J.1008.2012.00298 |
| 投稿时间：2011-10-20修订日期：2012-01-31 |
| 基金项目: |
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| Epidural neostigmine for labor pain: a meta-analysis |
| CHEN Cheng-wen1,CHEN Qian-bo2,OUYANG Qing1,LIU Fang-ting1,YUAN Hong-bin1* |
(1. Department of Anesthesia, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
2. Department of Anesthesia, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding author.) |
| Abstract: |
| Objective To evaluate the efficacy and safety of epidural neostigmine in management of labor pain. Methods Randomized controlled trials (RCTs) about epidural neostigmine combined with local anesthetics or opioids (experimental group) versus local anesthetics or opioids alone (control group) in management of labor pain were retrieved from Cochrane Library, PubMed, EMbase, Wanfang Database, CNKI, and CBMdisc from the date of their establishment to September 2011. The methodological quality of included RCTs was evaluated by two reviewers independently, and meta-analysis was conducted with the included RCTs using RevMan 5.1.4 software. Continuous variables were dealt with mean difference and 95% confidence interval(CI), and the dichotomous variables were dealt with odd ratio and 95% CI. Results We identified 4 RCTs including 282 patients. The results of meta-analyses showed that the values of visual analogue scale (VAS) were significantly lower in the experimental group compared with the control group |
| Key words: neostigmine epidural analgesia obstetrical analgesia meta-analysis |
