Abstract:
BACKGROUND:Remifentanil has been suggested for the induction of general anaesthesia for caesarean section. We aimed to define remifentanil effects on maternal stress response as well as neonatal effects. METHODS:Relevant articles were retrieved by a systematic literature search. Randomized, controlled trials comparing remifentanil use before delivery with placebo were selected. Maternal outcome parameters were blood pressure and heart rate; neonatal effects included the need for mask ventilation and intubation, base excess, pH values, Apgar < 7 at 1 and 5 min. The random effects model was used for meta-analysis; risk ratio or weighted mean difference (WMD) and 95% confidence interval (95% CI) were calculated. RESULTS:Five articles including 186 patients were identified. Highest and lowest systolic blood pressure were significantly lower in the remifentanil group (WMD: -29.98, -50.90 to -9.07 mmHg, 95% CI; P = 0.005; and WMD: -12.46, -18.21 to -6.71 mmHg, 95% CI; P < 0.0001), the lowest heart rate was significantly lower after remifentanil treatment (WMD: -8.22, -11.67 to -4.78, 95% CI; P < 0.00001). Base excess was significantly higher in infants of remifentanil-treated mothers (WMD: 1.15, -0.27 to 2.03, 95% CI; P = 0.01); pH was also higher in the remifentanil group, but significance was missed (P = 0.07). No differences were observed for Apgar values or the need of airway assist. CONCLUSION:Remifentanil was found to attenuate the maternal circulatory response to intubation and surgery. Higher base excess and pH suggest a beneficial effect on the neonatal acid-base status. A trial with adequate power is warranted that addresses neonatal side-effects of remifentanil.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Heesen M,Klöhr S,Hofmann T,Rossaint R,Devroe S,Straube S,Van de Velde Mdoi
10.1111/j.1399-6576.2012.02723.xsubject
Has Abstractpub_date
2013-01-01 00:00:00pages
29-36issue
1eissn
0001-5172issn
1399-6576journal_volume
57pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. METHODS:In this randomized crossover study, children aged 4.1-16.1 years und...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:1975-01-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
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pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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