| Objective:To evaluate the clinical effect of muscle relaxant used in the tracheobronchial foreign body removal in Children.Methods:We searched Chinese database,including Wan Fang data, Chinese National Knowledge Infrastructure,CSCD Med.We also searched English database, including EMBASE?Pub Med? Springerlink?Ovid?Web of Science.Besides,we searched the references of all identified study.To find the intravenous injection of muscle relaxant in comparison with placebo or blank control group.A randomized controlled trial of the clinical effect of muscle relaxant in the removal of foreign bodies in the trachea and bronchus.Our study evaluated the clinical effects including intraoperative complications( hypoxic event,choking and coughing, laryngospasm, breath holding,body movement),postoperative complications( hypoxic event,laryngeal edema, etc),the operation time,and anesthesia recovery time.Two researchers reviewed and selected trials form searches according to inclusion and exclusion criteria independently,assessed study quality and risk of bias,and then meta-analysis was performed using Rev Man 5.2.Results:We included nine related studies in this systematic review,involving 1295participants( 754 muscle relaxant group and 541 control group).Muscle relaxant reduce the risk of laryngospasm,breath holding,coughing and choking,body movement.At the same time,the operation time and the anesthesia recovery time were shorted. Which,compliations,risk ratio( RR) were 0.28( 95% CI 0.16 to 0.47),0.17( 95% CI 0.09 to0.31), 0.09( 95% CI 0.03 to 0.25),0.21( 95% CI 0.16 to 0.29),And need to control the number of cases( NNT) respectively 13.1,10.9,4.9,4.0,there was no significant difference in reducing the incidence of hypoxic events, and the risk ratio( RR)was0.59( 95% CI 0.34 to 1.02).The operation time and the anesthesia recovery time standardization mean difference( SMD) were-1.21( 95% CI-2.05 to-0.37),-2.30( 95% CI-3.43 to-1.16).Then, evaluation of the incidence of postoperative complications, there were only five studies to evaluate in the literature,and one of them described the incidence of postoperative airway spasm with statistical significance,its RR 0.13( 95% CI 0.02 to0.93),NNT was 4.0. Two studies have been conducted to compare the incidence of postoperative laryngeal edema and no significant difference,the RR was 1.09( 95% CI0.38 to 3.11). Another two studies compared the incidence of postoperative hypoxia events and not statistically significant,the RR was 0.82( 95% CI 0.05 to 12).In the postoperative respiratory depression,postoperative airway obstruction and postoperative severe cough compared to the rate was only one literature into,in statistics showed no significance,the RR were 0.25( 95% CI 0.03 to 2.02),0.60( 95% CI 0.27 to 1.33), 2.79( 95% CI 0.62 to 12.57),In the use of muscle relaxant safety,in the literature, there were no reports of adverse reactions, such as delayed recovery after the use of muscle relaxation.Conclusion:The use of muscle relaxant can reduce the incidence of the tracheobronchial foreign body removal intraoperative complicat ons(including laryngosspasm,breath holding,choking and coughing,body movement),and shorten the operation time and the anesthesia recovery time. |
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