BACKGROUND The perioperative use of vasoactive drugs is ubiquitous in clinical anaesthesia; yet, the drugs, doses, and haemodynamic targets used are highly variable. Our objectives were to determine whether the perioperative administration of vasoactive drugs reduces mortality, morbidity, and length of stay in adult patients (aged 16 yr or older) undergoing major abdominal surgery. METHODS MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for peer-reviewed RCTs with no language or date restrictions. Studies that assessed the intraoperative use of vasoactive drugs were included. Title, abstract, and full-text screening was performed. Risk of bias for each outcome measure was conducted. We calculated the risk ratio (RR) using the Mantel-Haenszel random-effects model with corresponding 95% confidence interval (CI) for dichotomous outcomes, and mean difference using the inverse variance random-effects model with corresponding 95% CI for continuous outcomes. RESULTS Twenty-six studies (5561 participants) were included. There was no difference in mortality at the longest follow-up with an RR of 0.84 (95% CI: 0.63-1.12; P=0.23). The intervention significantly reduced the number of patients with one or more postoperative complications; RR: 0.76 (95% CI: 0.66-0.88; P=0.0002). Hospital length of stay was reduced by 0.91 days in the intervention group. CONCLUSIONS This review is limited by the quality and sample size of individual studies, and the heterogeneity of the settings, interventions, and outcome measures. Perioperative administration of vasoactive drugs may reduce postoperative complications and hospital length of stay in adult patients having major abdominal surgery.

中文翻译：

---

对大腹部手术后围手术期使用血管活性药物对术后结局的系统评价和荟萃分析。

背景技术在临床麻醉中围手术期使用血管活性药物是普遍存在的。但是，所使用的药物，剂量和血流动力学指标变化很大。我们的目标是确定围手术期使用血管活性药物是否能降低接受大腹部手术的成年患者（16岁或以上）的死亡率，发病率和住院时间。方法检索MEDLINE，EMBASE和对照试验的Cochrane中央登记册，以寻找没有语言或日期限制的经过同行评审的RCT。包括评估术中使用血管活性药物的研究。进行标题，摘要和全文筛选。每种结果测度均存在偏倚风险。我们使用Mantel-Haenszel随机效应模型和二分结果分别以95％置信区间（CI）来计算风险比（RR），并使用具有95％CI的连续方差的逆方差随机效应模型来计算均值差。结果纳入了26项研究（5561名参与者）。在最长的随访中，死亡率无差异，RR为0.84（95％CI：0.63-1.12； P = 0.23）。干预显着减少了具有一种或多种术后并发症的患者的数量；RR：0.76（95％CI：0.66-0.88； P ＝ 0.0002）。干预组的住院时间减少了0.91天。结论这项审查受到个别研究的质量和样本量以及设置，干预措施和结果指标异质性的限制。