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Effect of dexmedetomidine on preventing postoperative agitation in children: a meta-analysis.

Ni J, Wei J, Yao Y, Jiang X, Luo L, Luo D - PLoS ONE (2015)

Bottom Line: Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others.No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.

ABSTRACT

Background: Emergence agitation (EA) is one of the most common postoperative complications in children. The purpose of this meta-analysis is to assess the effect of dexmedetomidine for preventing postoperative agitation in children.

Methods: We searched the Cochrane Central Register of Controlled Trails, MEDLINE, and EMBASE. Randomized controlled trials were included. The following outcome measures were evaluated: incidence of EA, number of patients requiring rescue, time to eye-open, time to extubation, time to discharge from the postanesthesia care unit (PACU).

Results: We analyzed 19 trials (1608 patients) that met the inclusion criteria. Compared with placebo, intravenous dexmedetomidine significantly reduced the incidence of EA [risk ratio (RR) 0.34, 95% confidence interval (CI) 0.25-0.44, P<0.00001). Dexmedetomidine also decreased the incidence of severe pain (RR 0.41, 95% CI 0.27-0.62, P<0.0001) and requirement of a rescue drug (RR 0.31, 95% CI 0.18-0.53, P<0.0001). However, compared with placebo, dexmedetomidine increased the time to eye-open by 0.98 min (P = 0.01) and the time to PACU discharge by 4.63 min (P = 0.02). Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others. No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.

Conclusions: Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs. It slightly increased the time to eye-open and the time to PACU discharge. Dexmedetomidine was also more beneficial than propofol or fentanyl in preventing EA.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of included/excluded studies.
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pone.0128450.g001: Flow diagram of included/excluded studies.

Mentions: Fig 1. shows a flow diagram of the trial selection process. A total of 60 potential articles from electronic databases were identified. We reviewed 27 records in full after screening the titles and abstracts. Finally, 19 trials (S1 References) with a total of 1608 patients were included, and relevant data were extracted (Table 1). All of the included studies were of parallel, double-blind, randomized, controlled design. A total of 15 participants in two trials were dropouts [7,8].


Effect of dexmedetomidine on preventing postoperative agitation in children: a meta-analysis.

Ni J, Wei J, Yao Y, Jiang X, Luo L, Luo D - PLoS ONE (2015)

Flow diagram of included/excluded studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440759&req=5

pone.0128450.g001: Flow diagram of included/excluded studies.
Mentions: Fig 1. shows a flow diagram of the trial selection process. A total of 60 potential articles from electronic databases were identified. We reviewed 27 records in full after screening the titles and abstracts. Finally, 19 trials (S1 References) with a total of 1608 patients were included, and relevant data were extracted (Table 1). All of the included studies were of parallel, double-blind, randomized, controlled design. A total of 15 participants in two trials were dropouts [7,8].

Bottom Line: Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others.No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.

ABSTRACT

Background: Emergence agitation (EA) is one of the most common postoperative complications in children. The purpose of this meta-analysis is to assess the effect of dexmedetomidine for preventing postoperative agitation in children.

Methods: We searched the Cochrane Central Register of Controlled Trails, MEDLINE, and EMBASE. Randomized controlled trials were included. The following outcome measures were evaluated: incidence of EA, number of patients requiring rescue, time to eye-open, time to extubation, time to discharge from the postanesthesia care unit (PACU).

Results: We analyzed 19 trials (1608 patients) that met the inclusion criteria. Compared with placebo, intravenous dexmedetomidine significantly reduced the incidence of EA [risk ratio (RR) 0.34, 95% confidence interval (CI) 0.25-0.44, P<0.00001). Dexmedetomidine also decreased the incidence of severe pain (RR 0.41, 95% CI 0.27-0.62, P<0.0001) and requirement of a rescue drug (RR 0.31, 95% CI 0.18-0.53, P<0.0001). However, compared with placebo, dexmedetomidine increased the time to eye-open by 0.98 min (P = 0.01) and the time to PACU discharge by 4.63 min (P = 0.02). Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others. No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.

Conclusions: Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs. It slightly increased the time to eye-open and the time to PACU discharge. Dexmedetomidine was also more beneficial than propofol or fentanyl in preventing EA.

No MeSH data available.


Related in: MedlinePlus