مقایسه کاربتوسین با اکسی‌توسین در بروز عوارض پس از بیهوشی در زنان با بارداری پرخطر کاندید سزارین: مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 دستیار تخصصی پاتولوژی، دانشکده پزشکی، دانشگاه پزشکی شهید صدوقی یزد، یزد، ایران.

2 متخصص زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 دستیار تخصصی بیماری‌های پوست، دانشکده پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

4 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور، اهواز، ایران.

5 استادیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

10.22038/ijogi.2025.88247.6445

چکیده

مقدمه: با توجه به تفاوت‌ها و تناقض‌های موجود در مطالعات قبلی درباره مقایسه کاربتوسین و اکسی‌توسین از نظر بروز عوارض جانبی پس از بیهوشی در زنان باردار پرخطر، مطالعه حاضر با هدف مقایسه کاربتوسین با اکسی‌توسین در بروز عوارض پس از بیهوشی در زنان با بارداری پرخطر کاندید سزارین به‌صورت مرور سیستماتیک انجام شد.
روش‌کار: این مطالعه مرور سیستماتیک و متاآنالیز بر اساس دستورالعمل PRISMA و با هدف مقایسه شیوع عوارض جانبی پس از بیهوشی در زنان باردار پرخطر تحت سزارین دریافت‌کننده کاربتوسین یا اکسی‌توسین انجام شد. جستجو مقالات منتشر شده به دو زبان فارسی و انگلیسی در پایگاه‌های PubMed، Web of Science، Scopus،ClinicalTrials.gov و Google Scholar و پایگاه‌های ایرانی شامل SID و ایران‌داک تا می ۲۰۲۵ صورت گرفت. داده‌ها با استفاده از نسبت شانس و تفاوت میانگین تحلیل و ناهمگنی با شاخص I² بررسی شد.
یافته ­ها: در این 6 مقاله، تعداد 1124 نفر شرکت کرده بودند؛ نسبت شانس حالت تهوع و/یا استفراغ در دریافت کنندگان کاربتوسین حدود 59/0 کاهش یافت، هرچند این کاهش از نظر آماری معنادار نبود. نسبت شانس سردرد 53/0 بود که کاهش معنی‌دار و با سازگاری بالا را نشان داد. نسبت شانس درد شکمی 69/0 بود که تفاوت معنادار نبود. نسبت شانس تب 69/0 گزارش شد که تفاوت معنی‌داری نداشت و ناهمگنی بالا بود. نسبت شانس افت فشار خون 57/1 بود که عدم معنی‌داری و تنوع قابل توجه نتایج را نشان می‌داد.
نتیجه ­گیری: کاربتوسین می‌تواند به‌طور معناداری بروز سردرد پس از بیهوشی را کاهش دهد، اما در سایر عوارض جانبی مورد بررسی (تهوع و استفراغ، افت فشار خون، درد شکمی و تب) تفاوت معناداری نسبت به اکسی‌توسین مشاهده نشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Carbetocin versus Oxytocin in the Incidence of Post-Anesthesia Complications in High-Risk Pregnant Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis

نویسندگان [English]

  • Mahboubeh Heydari 1
  • Elina Bairamzadeh 2
  • Hajir Mehrban 3
  • Ehsan Tasdighi 4
  • Sima Miraghaei 5
1 Resident, Department of Pathology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 Obstetrician and Gynecologist, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Resident, Department of Dermatology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4 General Physician, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
5 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Given the inconsistencies and contradictions across previous studies regarding comparison of carbetocin and oxytocin in terms of postoperative adverse effects in high‑risk pregnant women, the present study was conducted with aim to compare carbetocin vs. oxytocin in the incidence of post-anesthesia complications among high‑risk parturients undergoing cesarean delivery.
Methods: This systematic review and meta‑analysis was performed in accordance with the PRISMA guidelines to compare the incidence of post-anesthesia adverse effects in high‑risk pregnant women undergoing cesarean section who received either carbetocin or oxytocin. Studies published in English or Persian was searched up to May 2025 in PubMed, Web of Science, Scopus, ClinicalTrials.gov, Google Scholar, and the Iranian databases of SID and IranDoc. Data were synthesized using odds ratios and mean differences, and heterogeneity was assessed using the I² statistic.
Results: Across the six included studies, a total of 1,124 participants were analyzed. The odds of nausea and/or vomiting were reduced to approximately 0.59 among patients receiving carbetocin; however, this reduction did not reach statistical significance. The odds ratio for headache was 0.53, which showed a significant reduction with high consistency. The odds ratio for abdominal pain was 0.69, which showed no significant difference. The odds ratio for fever was 0.69, which showed no significant difference with high heterogeneity. The odds ratio for hypotension was 1.57, indicating no significant difference with considerable variability across studies.
Conclusion: Carbetocin significantly reduces the incidence of headache following anesthesia compared to oxytocin, but no statistically significant differences were observed between the two drugs for other complications including nausea and vomiting, hypotension, abdominal pain, and fever.

کلیدواژه‌ها [English]

  • Carbetocin
  • Cesarean Section
  • Complications
  • High-Risk Pregnancy
  • Oxytocin
  • Post-Anesthesia

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 10
دی 1404
صفحه 89-101

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