CO2水平的轻度变化对器官灌注和组织炎症的影响是众所周知的,而全身麻醉下的高碳酸血症对恶心和呕吐等不良事件的影响,或住院时间几乎没有检查。我们的荟萃分析的目的是确定成人患者全身麻醉中高碳酸血症与正常碳酸血症的可能积极作用。
我们进行了一项比较全身麻醉成年患者高碳酸血症与正常碳酸血症的平行臂随机对照试验的系统评价。在2018年7月和2019年9月,我们搜索了“CENTRAL,\"MEDLINE,和“Embase,检查所有纳入研究的参考文献列表和相关系统评价,以获得更多的试验参考文献.两名综述作者独立评估纳入试验,提取的数据,并完成了所有纳入研究的偏倚风险评估。
在摘要筛选30篇全文论文后,我们的搜索确定了297条记录,有待进一步审查。十篇出版物符合我们的纳入标准,并用于本系统综述的叙述性描述。三项研究符合正常碳酸血症与高碳酸血症的荟萃分析结果:拔管时间和不良事件。平均而言,高碳酸血症组的拔管时间显著缩短,平均差3.78(95%CI0.85~6.71).关于不良事件没有发现差异。
我们的研究结果并不能证明在全身麻醉期间CO2分压水平升高的积极影响。一个精心策划的,足够有力的随机对照试验在未来是可取的.
The effect of mild changes in CO2 levels to organ perfusion and tissue inflammation are well known, whereas an influence of hypercapnia under general anesthesia on adverse events as nausea and vomiting, or length of hospital stay is barely examined. The goal of our meta-analysis was to identify possibly positive effects of hypercapnia versus
normocapnia in general anesthesia in adult patients.
We conducted a systematic
review of parallel-arm randomised controlled trials comparing hypercapnia versus
normocapnia in adult patients undergoing general anesthesia. In July 2018 and September 2019 we searched \"CENTRAL‿, \"MEDLINE‿, and \"Embase‿, checked reference lists of all included studies and relevant systematic reviews for additional references to trials. Two
review authors independently assessed trials for inclusion, extracted data, and completed a \"Risk of bias‿ assessment for all included studies.
Our search identified 297 records after abstract screening 30 full-text papers remained for further examination. Ten publications met our inclusion criteria and were used for narrative description of this systematic review. Three studies were eligible for the meta-analysis
normocapnia versus hypercapnia with the outcomes: time to extubation and adverse events. On average, time to extubation was significantly reduced in the hypercapnia group with a mean difference 3.78 (95% CI 0.85 to 6.71). No difference was found regarding adverse events.
The findings of our study do not enable us to produce evidence of a positive influence of increased CO2 partial pressure levels during general anesthesia. A well-planned, adequately powered randomized controlled trial would be desirable in the future.