■支气管镜检查是一种常见的临床诊断方法。然而,由于其独特的操作特点,该程序通常会引起患者的不适和疼痛。舒芬太尼和纳美芬的联合使用在有效逆转阿片类药物引起的呼吸抑制而不损害镇痛效果方面具有优势。然而,关于在支气管镜检查中联合使用不同剂量舒芬太尼和纳美芬的综合分析报告尚未报道。本课题旨在探讨不同剂量舒芬太尼复合纳美芬在支气管镜检查中的应用效果。
■使用基于计算机和手动的方法检索相关关键字,我们搜索了PubMed的数据库,Embase,WebofScience,科克伦图书馆,中国国家知识基础设施(CNKI),和万方自始至今寻找评价不同剂量舒芬太尼联合纳美芬在支气管镜检查中应用效果的研究。对纳入研究的质量进行了评估,采用RevMan5.3软件进行Meta分析。
■总共六篇英语文章,包括随机对照试验和综述,由774名参与者组成,最终被包括在内。对照组采用常规治疗,干预组采用不同剂量舒芬太尼联合纳美芬。Meta分析结果表明,与常规治疗相比,这种方法显着改善了生命体征,如收缩压[SBP;平均差异(MD)=21.44,P<1×10-5]和舒张压(DBP;MD=22.52,P<1×10-5),心率(HR;MD=25.16,P<1×10-5),和氧饱和度(SpO2;MD=30.16,P<1×10-5)。共有4项研究集中在镇静作用上,舒芬太尼联合纳美芬明显优于常规治疗(P<1×10-5)。不良事件分析表明,与对照组相比,联合治疗在高血压和心动过速发生率方面具有更好的效果(P<0.001,P<1×10-5)。Riker镇静-躁动评分(SAS评分)显著降低(P<0.05)。然而,其他不良事件比较差异无统计学意义(P>0.05)。亚组分析显示,与0.2和0.8µg/kg相比,舒芬太尼浓度为0.4µg/kg时的不良反应较少,只有高血压有显著差异。
■在临床实践中,考虑使用舒芬太尼联合纳美芬可以改善患者在支气管镜检查期间的体验。然而,应该注意的是,这种方法可能不适合所有患者,临床医生需要根据患者情况和个体差异选择合适的镇痛和镇静方法进行支气管镜检查。此外,重要的是要认识到这项研究有一些局限性,需要进一步的研究来评估这种方法在其他类型的内窥镜检查中的有效性和安全性,以及比较不同药物组合的效果和安全性。
UNASSIGNED: Bronchoscopy examination is a common clinical diagnostic method. However, due to its unique operational characteristics, the procedure often induces discomfort and pain in patients. The combined use of
sufentanil and nalmefene offers advantages in effectively reversing opioid-induced respiratory depression without compromising analgesic effects. However, a comprehensive analysis report on the combined use of different doses of
sufentanil and nalmefene in bronchoscopy examinations has not been reported. The aim of this subject is to investigate the application effects of different doses of
sufentanil combined with nalmefene in bronchoscopy.
UNASSIGNED: Using computer-based and manual methods to retrieve relevant keywords, we searched the databases of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang from inception to the present to find studies evaluating the application effects of different doses of sufentanil combined with nalmefene in bronchoscopy examinations. The quality of the included studies was assessed, and meta-analysis was conducted using RevMan 5.3 software.
UNASSIGNED: A total of six English-language articles, involving randomized controlled trials and reviews, and comprising 774 participants, were finally included. The control group used conventional therapy, whereas the intervention group used different doses of sufentanil combined with nalmefene. Meta-analysis results indicated that compared to conventional therapy, this approach significantly improved vital signs such as systolic blood pressure [SBP; mean difference (MD) =21.44, P<1×10-5] and diastolic blood pressure (DBP; MD =22.52, P<1×10-5), heart rate (HR; MD =25.16, P<1×10-5), and oxygen saturation (SpO2; MD =30.16, P<1×10-5). A total of 4 studies focused on sedative effects, and that of
sufentanil combined with nalmefene was significantly superior to conventional therapy (P<1×10-5). Analysis of adverse events showed that the combined therapy had better outcomes in terms of hypertension and tachycardia incidence compared to the control group (P<0.001, P<1×10-5), and Riker sedation-agitation scale (SAS score) was significantly reduced (P<0.05). However, there were no significant differences in other adverse events (P>0.05). Subgroup analysis showed fewer adverse reactions at 0.4 µg/kg
sufentanil concentration compared to 0.2 and 0.8 µg/kg, with only hypertension differing significantly.
UNASSIGNED: In clinical practice, considering the use of sufentanil combined with nalmefene can improve patients\' experience during bronchoscopy examinations. However, it should be noted that this approach may not be suitable for all patients, and clinicians need to choose appropriate analgesic and sedative methods for bronchoscopy examinations based on patients\' conditions and individual differences. Furthermore, it is important to recognize that this study has some limitations and further research is needed to evaluate the efficacy and safety of this approach in other types of endoscopic examinations, as well as to compare the effects and safety of different drug combinations.