Abstract：
BACKGROUND: Rapid sequence intubation is an airway rescue and protection technique in which different sedatives are used to perform orotracheal intubation. Etomidate, due to its pharmacokinetic and pharmacodynamic qualities, particularly hemodynamic stability, is the most widely used sedative in this scenario. However, its superiority over other sedatives is controversial.
METHODS: We performed a meta-analysis using a pre-designed protocol and PRISMA guidelines to evaluate the mean difference between systolic blood pressure before and after administration of the sedative. We also analyzed the relative risks of hypotension.
RESULTS: Ten studies were included. The incidence of hypotension in patients receiving etomidate ranged from 6.4% to 75.2%, and between 24.0% and 65.9% in patients receiving other sedatives. No significant differences were found in the mean difference in systolic blood pressure during pre-intubation 0.01 mm Hg (95% CI: -0.90; 0.92) or in post-intubation 0.98 mmHg (95% CI: -0.24; 2.20). The relative risk analysis showed that the risk of hypotension is equal to an RR of 1.19 (95% CI: 0.92-1.54) between those who received etomidate and those who received the other sedatives.
CONCLUSIONS: The risk of hypotension after rapid intubation sequence with etomidate does not differ significantly compared to other sedatives. However, the studies included in this review were heterogeneous.
METHODS: We performed a meta-analysis using a pre-designed protocol and PRISMA guidelines to evaluate the mean difference between systolic blood pressure before and after administration of the sedative. We also analyzed the relative risks of hypotension.
RESULTS: Ten studies were included. The incidence of hypotension in patients receiving etomidate ranged from 6.4% to 75.2%, and between 24.0% and 65.9% in patients receiving other sedatives. No significant differences were found in the mean difference in systolic blood pressure during pre-intubation 0.01 mm Hg (95% CI: -0.90; 0.92) or in post-intubation 0.98 mmHg (95% CI: -0.24; 2.20). The relative risk analysis showed that the risk of hypotension is equal to an RR of 1.19 (95% CI: 0.92-1.54) between those who received etomidate and those who received the other sedatives.
CONCLUSIONS: The risk of hypotension after rapid intubation sequence with etomidate does not differ significantly compared to other sedatives. However, the studies included in this review were heterogeneous.
摘要：
背景：快速顺序插管是一种气道抢救和保护技术，其中使用不同的镇静剂进行经气管插管。依托咪酯,由于其药代动力学和药效学性质，尤其是血液动力学稳定性，是这种情况下使用最广泛的镇静剂。然而,它优于其他镇静剂是有争议的。
方法：我们使用预先设计的方案和PRISMA指南进行了荟萃分析，以评估镇静剂给药前后收缩压之间的平均差异。我们还分析了低血压的相对风险。
结果：纳入10项研究。接受依托咪酯的患者低血压的发生率为6.4％至75.2％，在接受其他镇静剂的患者中，占24.0%至65.9%。插管前0.01mmHg（95％CI：-0.90;0.92）或插管后0.98mmHg（95％CI：-0.24;2.20）的收缩压平均差异无显着差异。相对风险分析显示，低血压的风险等于接受依托咪酯和接受其他镇静剂的患者的RR为1.19（95％CI：0.92-1.54）。
结论：与其他镇静剂相比，依托咪酯快速插管后低血压的风险没有显著差异。然而,纳入本综述的研究具有异质性.
方法：我们使用预先设计的方案和PRISMA指南进行了荟萃分析，以评估镇静剂给药前后收缩压之间的平均差异。我们还分析了低血压的相对风险。
结果：纳入10项研究。接受依托咪酯的患者低血压的发生率为6.4％至75.2％，在接受其他镇静剂的患者中，占24.0%至65.9%。插管前0.01mmHg（95％CI：-0.90;0.92）或插管后0.98mmHg（95％CI：-0.24;2.20）的收缩压平均差异无显着差异。相对风险分析显示，低血压的风险等于接受依托咪酯和接受其他镇静剂的患者的RR为1.19（95％CI：0.92-1.54）。
结论：与其他镇静剂相比，依托咪酯快速插管后低血压的风险没有显著差异。然而,纳入本综述的研究具有异质性.
