【原】【罂粟摘要】一项右旋美托咪定与咪达唑仑在程序性镇静的疗效和安全性比较的系统回顾

一项右旋美托咪定与咪达唑仑在程序性镇静的疗效和安全性比较的系统回顾

贵州医科大学  麻醉与心脏电生理课题组

翻译：王璐   编辑：王婷婷  审校：曹莹  

背景：系统地回顾比较右美托咪定和咪达唑仑用于程序性镇静的有效性和安全性的文献。

方法：我们检索了MEDLINE、EMBASE和科克伦，以查找截至2016年6月20日比较右美托咪定和咪达唑仑用于手术镇静的临床试验。入选标准：临床试验、人类受试者、成人受试者（18岁），以英语、德语、法语或荷兰语撰写的文章，使用研究药物进行清醒镇静，至少一组接受右美托咪定，一组接受咪达唑仑。排除标准：重症监护患者、儿科受试者和按照方案使用除急救药物以外的其他镇静药物。疗效比较的结局指标为患者和临床医生满意度评分和疼痛评分;安全性比较的结局指标为低血压、缺氧以及循环和呼吸系统并发症。

结果： 我们确定了 89 篇论文，其中 12 篇满足纳入和排除标准；这些研究包括 883 名患者。右美托咪定与咪达唑仑相比，患者和操作者的满意度更高。接受右美托咪定治疗的患者疼痛较轻，对镇痛剂的需求也较低。呼吸和血液动力学安全性相似。

结论： 右美托咪定是用于程序镇静的咪达唑仑有前途的替代品。右美托咪定在手术过程中为患者和临床医生提供了更多的舒适感，且与咪达唑仑安全性相似。

原始文献来源：Clemens R. M. Barends,Anthony Absalom,Bauckevan Minnen,et,al.Dexmedetomidine versus Midazolam inProcedural Sedation. A Systematic Review of Efficacy and Safety.[J].PLOS ONE . 2017 January 20;|DOI:10.1371/journal.pone.0169525

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

purpose: To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation

Method: We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam. Exclusion criteria: patients in intensive care, pediatric subjects and per protocol use of additional sedative medication other than rescue medication. Outcome measures for efficacy comparison were patient and clinician satisfaction scores and pain scores; outcome measures for safety comparison were hypotension, hypoxia, and circulatory and respiratory complications.

Results: We identified 89 papers, of which 12 satisfied the inclusion and exclusion criteria; 883 patients were included in these studies. Dexmedetomidine was associated with higher patient and operator satisfaction than midazolam. Patients receiving dexmedetomidine experienced less pain and had lower analgesic requirements. Respiratory and hemodynamic safety were similar.

Conclusion: Dexmedetomidine is a promising alternative to midazolam for use in procedural sedation. Dexmedetomidine provides more comfort during the procedure for the patient and clinician. If carefully titrated, the safety profiles are similar.