地佐辛可预防依托咪酯诱导时肌阵挛的发生：一项随机试验的meta分析
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Using dezocine to prevent etomidate-induced myoclonus: a meta-analysis of randomized trials
背景与目的
本研究旨在评估地佐辛预注射预防依托咪酯诱导发生肌阵挛的有效性和安全性。
方 法
检索PubMed、Embase、Cochrane Library和中国国家知识基础设施(CNKI)，收集自成立至2016年7月关于地佐辛预注射预防依托咪酯诱导产生肌阵挛的相关随机对照试验(rct)。两名研究人员独立筛选文献，提取数据，按照纳入和排除标准评估偏倚风险，然后使用RevMan 5.2进行meta分析。
结 果
本研究共纳入6项随机对照试验。meta分析显示1)地佐辛预注射可降低依托咪酯所致肌阵挛发生率(相对危险度[RR] =0.25, 95% CI [0.13, 0.50]， P,0.0001)，与亚组分析结果一致;2)地佐辛预注射可降低轻度、中度、重度肌阵挛的发生率;3)地佐辛与依托咪酯致头晕、恶心发生率增加无相关性(RR =2.83, 95% CI [0.66, 12.08]， P=0.6);而地地辛在给药后并没有降低心率(均值差异=1.06,95% CI [-4.08, 6.19]， P=0.69)。
结 论
地佐辛预注射既能降低依托咪酯所致肌阵挛的发生率，又能减轻肌阵挛的严重程度，但不会增加头晕、恶心或影响心率。
原始文献摘要
Yu Zhu,Yuting Yang,hengmao Zhou，et,al.Using dezocine to prevent etomidate-induced myoclonus: a meta-analysis of randomized trials[J]；Drug Design, Development and Therapy2017:11 2163–2170
Objective: This study was designed to evaluate the efficacy and safety of preinjection of dezocine in preventing etomidate-induced myoclonus.
Methods: PubMed, Embase, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched to collect relevant randomized controlled trials (RCTs) from inception to July 2016 on the preinjection of dezocine in preventing etomidate-induced myoclonus. Two researchers independently screened literature, extracted data, and evaluated bias risks in accordance with inclusion and exclusion criteria, and then used RevMan 5.2 to perform the meta-analysis.
Results: A total of six RCTs were included in this study. The meta-analysis showed that 1) the preinjection of dezocine can reduce the incidence of etomidate-induced myoclonus (relative risk [RR] =0.25, 95% CI [0.13, 0.50], P,0.0001), which is consistent with the result of subgroup analysis; 2) the preinjection of dezocine can reduce the incidence of mild, moderate, and severe myoclonus; 3) dezocine was not related to an increasing incidence of etomidate-induced dizziness and nausea (RR =2.83, 95% CI [0.66, 12.08], P=0.6); and 4) dezocine did not reduce heart rates after the administration of etomidate (mean difference =1.06, 95% CI [-4.08, 6.19], P=0.69).
Conclusion: The preinjection of dezocine has the effect of both lowering the incidence of etomidate-induced myoclonus and easing the severity of myoclonus, but without increasing dizziness and nausea or affecting the heart rate.
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