Meta AnalysisID 3853
去氧肾上腺素治疗麻醉诱导低血压时对脑灌注的影响：一项系统评价计划书
CRD42018100740
What is the effect of intravenous phenylephrine on cerebral perfusion in adult patients when administered to treat anesthesia-induced hypotension?
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Record Fields
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- Meta Analysis Id
- 3853
- Evidence Id
- 12411
- Core Evidence Id
- 12411
- Source Meta Analysis Id
- 3808
- Herb2 Meta Analysis Id
- HBMA003808
- Crd Id
- CRD42018100740
- Title
- The effect of phenylephrine on cerebral perfusion when used to treat anesthesia-induced hypotension: a systematic review protocol
- Review Question
- What is the effect of intravenous phenylephrine on cerebral perfusion in adult patients when administered to treat anesthesia-induced hypotension?
- Study Type Included
- This review will consider both experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, and interrupted time-series studies. Only studies published in English will be included. Only studies published since 1999 will be included, as this time period correlates with the advent of cerebral oximetry technology in anesthesia practice using monitoring technology that is similar to today's devices.
- Condition Being Studied
- While the etiology of perioperative cognitive dysfunction in adults following surgery is likely multifactorial, intraoperative cerebral hypoperfusion is a commonly proposed mechanism. Intraoperative administration of phenylephrine is a ubiquitous practice among anesthesia providers that is believed to prevent cerebral hypoperfusion by increasing mean arterial pressure above a lower limit of 50 mm Hg to 70 mm Hg. However, evidence and expert opinion are emerging that phenylephrine may adversely affect cerebral oxygen saturation and cardiac output, despite its positive impact on mean arterial pressure. This systematic review informs evidence-based anesthesia practice by investigating the effect of phenylephrine on cerebral perfusion, when used to treat anesthesia induced hypotension.
- Participant
- Studies in the systematic review will include human subjects who are 18 years or over undergoing elective surgical procedures involving sedation, regional or general anesthesia provided by a nurse anesthetist or anesthesiologist. Studies in which subjects are undergoing intracranial surgical procedures will be excluded from this review.
- Animal
- Human Disease Modelled
- Intervention
- Studies in the systematic review will include those that evaluate the effect of intravenous phenylephrine administered as a bolus or continuous infusion to treat AIH. Studies must use dosages consistent with typical anesthesia practice, which is 40–200ug per bolus, or 10–200ug/minute for continuous infusion.
- Comparator Control
- Comparators include placebo, ephedrine, normal saline, or other vasopressor agents such as epinephrine, norepinephrine or dopamine.
- Main Outcome
- Outcomes for this systematic review include cerebral oxygen saturation or MCA blood flow velocity. Cerebral oxygen saturation must be measured using near infrared spectroscopy, and MCA blood flow velocity must be measured using transcranial doppler.
- Outcome Measure
- Additional Outcome
- Cardiac output, heart rate, MAP, length of stay, postoperative cognitive decline and mortality will be also be included as outcome variables, if available.
- Study Method
- Systematic review
- Keyword
- Anesthesia; Anesthesiology; Humans; Hypotension; Hypotension, Controlled; Phenylephrine
- Contact
- Joanna Briggs Institute JBI [email protected]
- Organisational Affiliation
- Rosalind Franklin University of Medicine and Science: a Joanna Briggs Institute Affiliated Group, Chicago, USA
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- https://journals.lww.com/jbisrir/Fulltext/2018/06000/The_effect_of_phenylephrine_on_cerebral_perfusion.8.aspx
- Review Type
- Language
- English
- Country
- United States of America
- Review Stage
- Review Ongoing
- First Submission Date
- 2018-07-03
- Registration Date
- 2018-07-27
- Anticipated Start Date
- 2018-05-15
- Anticipated Completion Date
- 2018-08-31
- Title Cn
- 去氧肾上腺素治疗麻醉诱导低血压时对脑灌注的影响：一项系统评价计划书
- Title En
- The effect of phenylephrine on cerebral perfusion when used to treat anesthesia-induced hypotension: a systematic review protocol
- Bilingual Status
- complete