Coadministration of intravenous calcium along with neostigmine for rapid neuromuscular blockade recovery: A systematic review and meta-analysis.

IF 17.7 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-01-01 Epub Date: 2023-04-07 DOI:10.4103/joacp.joacp_139_22

Puneet Khanna, Aditi Das, Soumya Sarkar

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Abstract

Postoperative residual curarization (PORC) and the impact of the coadministration of intravenous calcium along with an acetylcholinesterase inhibitor on it are not well addressed. Extensive electronic database screening was done until October 7, 2022 after enlisting the protocol of this systematic review in PROSPERO (CRD42021274879). Randomized controlled trials (RCTs) evaluating the impact of intravenous calcium and neostigmine coadministration on neuromuscular recovery were included in this meta-analysis. Our search retrieved four RCTs with a total of 266 patients. The application of calcium shortened the neuromuscular recovery time (SMD = -2.13, 95% confidence interval [CI]: -2.66 to -1.59, I² = 66%) and reduced the risk of PORC at 5 min (odds ratio [OR] = 0.21, 95% CI: 0.10-0.46, I² = 0%), with an improved train-of-four (TOF) ratio at 5 min (mean difference [MD] = 9.28, 95% CI: 4-14.57, I² = 66%). However, neither significant reduction in PORC at 10 min (OR = 0.41, 95% CI: 0.15-1.09, I² = 0%) nor a better TOF ratio was associated with coadministration of calcium (MD = 0.40, 95% CI: -1.3-2.11). Coadministration of calcium along with neostigmine during the early period of neuromuscular blockade reversal can be used to enhance neuromuscular recovery.

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静脉内钙与新斯的明联合用药用于神经肌肉阻滞的快速恢复

术后残余凝血（PORC）以及静脉注射钙剂和乙酰胆碱酯酶抑制剂对其的影响尚未得到很好的研究。在PROSPERO（CRD42021274879）中列入本系统综述的方案后，我们进行了广泛的电子数据库筛选，直至2022年10月7日。本荟萃分析纳入了评估静脉注射钙剂和新斯的明联合用药对神经肌肉恢复影响的随机对照试验（RCT）。我们检索到了四项 RCT，共有 266 名患者参加。应用钙剂缩短了神经肌肉恢复时间（SMD = -2.13，95% 置信区间[CI]：-2.66 至 -1.59，I2 = 66%），降低了 5 分钟时发生 PORC 的风险（几率比 [OR] = 0.21，95% 置信区间[CI]：0.10 至 0.46，I2 = 0%），改善了 5 分钟时的四次训练（TOF）比率（平均差 [MD] = 9.28，95% 置信区间[CI]：4 至 14.57，I2 = 66%）。然而，10 分钟时 PORC 的明显降低（OR = 0.41，95% CI：0.15-1.09，I2 = 0%）和 TOF 比率的改善（MD = 0.40，95% CI：-1.3-2.11）均与联合给药钙剂无关。在神经肌肉阻滞逆转的早期阶段联合使用钙剂和新斯的明可用于促进神经肌肉恢复。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.