Comparative Efficacy and Safety of Anesthetic and Sedative Regimens for Endoscopic Retrograde Cholangiopancreatography: A Network Meta-analysis.

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Diseases Pub Date : 2024-11-13 DOI:10.1159/000542380

Yufang Liu, Jifeng Xiao, Tian Chen, Dongdong Shi, Yan Qiao, Xingzhi Liao

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Abstract

Introduction: This study evaluates the efficacy and safety of various anesthetic and sedative regimens for Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures.

Methods: A systematic search was conducted across PubMed, Web of Science, Scopus, and Embase to identify randomized controlled trials (RCTs) published until March 2024. Primary outcomes included procedure time, patient satisfaction, oxygen saturation (SpO2), incidence of SpO2 below 90%, and adverse events. The analysis was performed using R software, analyzing continuous outcomes with mean differences and dichotomous outcomes with risk ratios.

Results: 42 RCTs were included. Combination therapies such as remifentanil plus tramadol and propofol plus midazolam plus pethidine demonstrated significantly shorter procedure times. Propofol plus oxycodone yielded higher patient satisfaction. Oxygenation results indicated that propofol plus fentanyl, oxycodone, and ketamine improved SpO2. Propofol plus oxycodone (RR<0.01), dexmedetomidine plus fentanyl (RR<0.01), propofol plus nalbuphine (RR=0.01), Mg sulfate plus propofol (RR=0.01), and propofol plus fentanyl (RR=0.02), showed a significant lower rate of patients with SpO2 below 90% compared to propofol. Midazolam plus pethidine plus dexmedetomidine (RR=0.01), propofol plus oxycodone (RR=0.09), and dexmedetomidine plus fentanyl (RR=0.2) exhibited lower rates of adverse events compared to propofol.

Conclusion: This study provides comprehensive evidence to guide clinical decision-making and optimize anesthetic management for ERCP procedures.

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内镜逆行胰胆管造影术中麻醉和镇静方案的疗效和安全性比较：网络 Meta 分析。

简介：本研究评估了内镜逆行胰胆管造影术（ERCP）中各种麻醉和镇静方案的有效性和安全性：本研究评估了内镜逆行胰胆管造影术（ERCP）中各种麻醉和镇静方案的有效性和安全性：在PubMed、Web of Science、Scopus和Embase上进行了系统检索，以确定2024年3月之前发表的随机对照试验（RCT）。主要结果包括手术时间、患者满意度、血氧饱和度（SpO2）、SpO2低于90%的发生率和不良事件。分析使用 R 软件进行，连续结果用平均差分析，二分结果用风险比分析：结果：共纳入 42 项研究。瑞芬太尼加曲马多、异丙酚加咪达唑仑加哌替啶等联合疗法明显缩短了手术时间。丙泊酚加羟考酮的患者满意度更高。吸氧结果表明，异丙酚加芬太尼、羟考酮和氯胺酮可改善 SpO2。异丙酚加羟考酮（RRC结论：这项研究为指导临床决策和优化 ERCP 手术的麻醉管理提供了全面的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Diseases 医学-胃肠肝病学

CiteScore

4.80

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： Each issue of this journal is dedicated to a special topic of current interest, covering both clinical and basic science topics in gastrointestinal function and disorders. The contents of each issue are comprehensive and reflect the state of the art, featuring editorials, reviews, mini reviews and original papers. These individual contributions encompass a variety of disciplines including all fields of gastroenterology. ''Digestive Diseases'' bridges the communication gap between advances made in the academic setting and their application in patient care. The journal is a valuable service for clinicians, specialists and physicians-in-training.