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摘要
Background and Objectives: Intrathecal epinephrine has been examined by clinical studies, but its effects on analgesia/anesthesia outcomes as well as on undesirable adverse effects is not clearly defined. The objective of this study was to examine the effects of intrathecal epinephrine on intrathecal anesthesia/analgesia.
Methods: We performed a meta-analysis, using a random-effects model. Effects of intrathecal epinephrine dose were evaluated by pooling studies into 3 dosage groups: low (1-100 mu g), intermediate (101-200 mu g), and high (>= 200 mu g). Metaregression analyses were also performed to examine the presence of a linear association between intrathecal epinephrine dose and effect size on evaluated outcomes.
Results: Twenty-four randomized clinical trials with 1,271 subjects were included. The mean (95% confidence interval [CI]) combined effects favored intrathecal epinephrine over placebo for duration of analgesia, 27.0 mins (20.8-33.3 mins); sensory, 35.0 mins (22.8-47.3 mins); and motor block, 32.2 mins (26.2-38.2 mins). The incidence of hypotension and postoperative nausea and vomiting (PONV) was greater for the low dose (1-100 mu g) intrathecal epinephrine group compared with placebo (odds ratios [95% CI], 3.0 [1.5-5.9] and 2.7 [1.5-4.8], respectively). A greater incidence of hypotension and PONV was not detected for the intermediate-dose group (101-200 mu g): odds ratios (95% CI) of 0.9 (0.5-1.7) and 1.6 (0.6-4.6), respectively.
Conclusions: Intrathecal epinephrine has dose-dependent clinical and adverse effects. Doses of 100 mu g or less prolonged sensory and motor block duration but were associated with greater incidence of hypotension or PONV. Intrathecal epinephrine doses greater than 100 mu g prolonged sensory and motor block and were not associated with greater incidence of hypotension and PONV.
- 出版日期2012-8
- 单位西北大学
