剖腹产是美国最常见的手术,也是全球最常见的手术之一。使用尽可能低剂量的麻醉剂,提供无痛分娩和最低不良事件是一个主要问题。通过汇集相关研究的数据,我们研究了罗哌卡因和舒芬太尼联合用药的有效性和安全性。我们搜索了PubMed,WebofSciences,Scopus,和CochraneLibrary,直到2021年12月底,并包括所有有关罗哌卡因和舒芬太尼联合数据的记录。我们使用ReviewManager将数据汇总为连续结果的平均差或二分结果的风险比,置信区间为95%。使用Cochrane偏差风险工具的第一版评估方法学质量。纳入7项随机临床试验,总样本量为730名女性;入选产妇的平均年龄为28至35岁。我们发现,舒芬太尼和罗哌卡因联合使用与CS期间意识和紧张的风险降低显着相关(由镇静水平1表示)(RR:0.05,95CI[0.01,0.33],P=0.002),寒战风险降低(RR=0.29,95CI[0.19,0.44],P<0.00001),恶心(RR=0.62,95CI[0.41,0.92],P=0.02),和呕吐(RR=0.27,95%CI[0.12,0.61],P=0.002)。然而,联合使用舒芬太尼和罗哌卡因与迟发性感觉阻滞有关(MD=0.41,95CI[0.13,0.68],P=0.004)和Bromage量表0显示的髋关节腿部屈曲运动阻滞较少(RR=7.1595CI[2.71,18.86],P<0.0001)。联合罗哌卡因和舒芬太尼与减少内脏疼痛和降低低血压的风险有关。颤抖,恶心,呕吐,与分离的罗哌卡因相比,心动过缓的发生率没有差异。虽然联合罗哌卡因和舒芬太尼与瘙痒的风险较高,据报道,瘙痒的发生率与舒芬太尼的使用剂量成正比.然而,罗哌卡因和舒芬太尼联合使用可能会稍微延迟感觉阻滞的开始,从而在T10时进行针刺,同时减少运动阻滞,但在CS期间女性意识和紧张的可能性较小.
Cesarean sections are the most common operations in the United States and one of the most common worldwide. Using the lowest possible dose of anesthetic that provides painless delivery with the lowest adverse events is a major concern. We investigated the efficacy and safety of combined
ropivacaine and sufentanil by pooling data from relevant studies. We searched PubMed, Web of sciences, Scopus, and Cochrane Library until the end of December 2021 and included all records with data about combined ropivacaine and sufentanil. We used
Review Manager to pool data as a mean difference for continuous outcomes or risk ratio for dichotomous outcomes with a 95% confidence interval. Methodological quality was appraised using version one of the Cochrane risks of bias tool. Seven Randomized clinical trials with a total sample size of 730 women were included; the mean age of enrolled parturients ranged from 28 to 35 years. We found that combined sufentanil and
ropivacaine were significantly associated with decreased risk of being aware and nervous during CS (presented by Sedation level 1) (RR: 0.05, 95%CI [0.01,0.33], P=0.002), decreased risk of shivering (RR=0.29, 95%CI [0.19,0.44], P<0.00001), nausea (RR=0.62, 95%CI [0.41, 0.92], P=0.02), and vomiting (RR=0.27, 95% CI [0.12, 0.61], P=0.002). However, combined sufentanil and ropivacaine slightly were associated with late-onset of sensory blockade (MD=0.41, 95%CI [0.13, 0.68], P=0.004) and less motor blockade of leg flexion at hip joint presented by Bromage Scale 0 (RR=7.15 95%CI [2.71, 18.86], P<0.0001). Combined
ropivacaine and sufentanil were associated with a reduction in visceral pain and lower risks of hypotension, shivering, nausea, and vomiting, compared to isolated ropivacaine, with no difference regarding the incidence of bradycardia. Although Combined ropivacaine and sufentanil were associated with a higher risk of pruritus, the incidence of pruritus was reportedly proportionate with the used dose of sufentanil. However, combined
ropivacaine and sufentanil may slightly delay the onset of the sensory blockade to pinprick at T10 with less motor blockade but with a smaller probability for women to be aware and nervous during CS.