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Meta-analysis of Sevoflurane and Ketamine in pediatric anesthesia maintenance

ZHOU Bin XIA Zhongyuan XUE Rui WU Yang Department of Anesthesiology,the People′s Hospital of Wuhan University,Hubei Province,Wuhan 430060,China  
Objective To systemically review effect and complication of Sevoflurane and Ketamine in pediatric anesthesia maintenance,and provide evidence for clinical decision.Methods All related literatures on Sevoflurane inhalation or Ketamine intravenous maintenance anesthesia in pediatrics,taking Sevoflurane and pediatric anesthesia maintenance or Ketamine and pediatric anesthesia maintenance as search terms in database of Pubmed,Chinese national knowledge infrastructure(CNKI),and VIP from establishment of its own database to December 2011,were Meta-analyzed by RevMan 5.1.1.Results 17 randomized controlled trial and 3 771 cases of child patients were included.Results of Meta-analysis were as follows.①Amount of oral secretion by Sevoflurane anesthesia was less than that of Ketamine [RR = 0.03,95%CI(0.01,0.09)].②Frequency of intraoperative body movement by Ketamine general anesthesia was higher than that by Sevoflurane general anesthesia [RR = 0.06,95%CI(0.03,0.12)].③Time to open eyes or move body anesthetized by Sevoflurane after surgery was shorter than that of Ketamine [WMD =-29.84,95%CI(-36.61,-23.07)].④Out of the operating room or post anesthesia care unit time in Sevoflurane was less than that of Ketamine [WMD =-21.41,95%CI(-29.99,-12.84)].⑤Incidence of postoperative restlessness in Sevoflurane was higher than that of Ketamine [RR = 0.07,95%CI(0.04,0.11)].⑥There was no statistical difference in vomiting condition after surgery between the two anesthetics [RR = 0.75,95%CI(0.61,0.93)].Conclusion Compared with Ketamine,available literatures indicate that less respiratory secretions after Sevoflurane anesthesia,less body movement in Sevoflurane maintenance,and faster postoperative recovery by Sevoflurane general anesthesia,but with a higher incidence of postoperative restlessness.
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