| Background:Dexmedetomidine has been widely used in the treatment of ICU sedation and perioperative anesthesia,because of its inhibition of stress response,maintaining hemodynamic stability,no respiratory inhibition,and many other advantages.It is still controversial whether the use of dexmedetomidine hydrochloride adjuvant anesthesia in one lung ventilation(OLV)during thoracic surgery will have an impact on intrapulmonary shunt(Qs/Qt).Objective: This study aims to provide a theoretical basis for the application of dexmedetomidine hydrochloride in one lung ventilation during thoracic surgery through meta-analysis the effect of dexmedetomidine hydrochloride on pulmonary shunt in patients that undergoing single-lung ventilation during anesthesia.Methods: We searched for randomized controlled trials(RCTs)regarding the changes in intrapulmonary shunt during one-lung ventilation(OLV)with intravenous infusion of dexmedetomidine in the databases PubMed 、 The Cochrane Library、Embase、CBM、CNKI、VIP、Wan-Fang 、Baidu 、Googleby computer,and the references of the included studies were also retrieved.We extracted data and assessed the quality of the literature and adopted RevMan 5.3to conduct meta-analysis on each effective index and employed funnel plot to test publication bias.Results:A total of 18 RCTs involving 884 patients were included in the meta-analysis.The patients were divided into 2 groups:the dexmedetomidine group(n=444)and the control group(n=402).The results of meta-analysis showed that,there were statistically significant difference between dexmedetomidine group and normal saline group in the Qs/Qt at 10 minutes after initiation of OLV [WMD=-7.47,95% CI(-9.63~-5.30),p<0.00001],15 minutes after initiation of OLV [WMD=-5.00,95% CI(-8.83~-1.17),p=0.01],30 minutes after initiation of OLV [WMD=-4.02,95% CI(-6.19~-1.85),p=0.0003],40 minutes after initiation of OLV[WMD=-3.13,95% CI(-5.47~-0.79),p=0.009]and 60 minutes after initiation of OLV [WMD=-3.23,95% CI(-5.23 ~-1.22),p=0.002].There was no statistical difference between dexmedetomidine group and normal saline group at 90 minutes after initiation of OLV[WMD=-1.54,95% CI(-3.30~0.23),p=0.09].Conclusion: The use of dexmedetomidine hydrochloride in single lung ventilation during thoracic anesthesia can reduce the intrapulmonary shunt during OLV in a certain extent,which is beneficial to prevent hypoxemia resulted from excessive intrapulmonary shunt during one lung ventilation. |
