Effects of intravenous dexmedetomidine on emergence agitation in children under
sevoflurane anesthesia: a meta-analysis of randomized controlled trials.
Author(s): Zhang C(1), Hu J(1), Liu X(2), Yan J(1).
Affiliation(s): Author information:
(1)Department of Anesthesiology, Xiangya Hospital, Central South University,
Changsha, China. (2)Department of Cardiology, The Third Xiangya Hospital of
Central South University, Changsha, China.
Publication date & source: 2014, PLoS One. , 9(6):e99718
OBJECTIVE: Emergence agitation (EA) is a common complication in children under
sevoflurane anesthesia. The aim of this meta-analysis was to evaluate the effects
of intravenous dexmedetomidine on EA in children under sevoflurane anesthesia.
METHODS: A comprehensive literature search was conducted to identify clinical
trials that evaluated the effects of intravenous dexmedetomidine and placebo on
EA in children under sevoflurane anesthesia. The search collected trials from
MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and
Web of Science. Analysis was conducted using STATA version 12.0. Data from each
trial were pooled using relative ratio (RR) for dichotomous data or weighted mean
difference (WMD) for continuous data and corresponding 95% confidence interval
(95% CI). Heterogeneity assessment, sensitivity analysis, and publication bias
were performed.
RESULTS: Twelve trials, in which 459 patients received dexmedetomidine and 353
patients received placebo, were included in this analysis. We found that
intravenous dexmedetomidine decreased the incidences of EA (RR = 0.346, 95% CI
0.263 to 0.453, P<0.001), and postoperative pain (RR = 0.405, 95% CI 0.253 to
0.649, P<0.001). Intravenous dexmedetomidine also prolonged extubation time (WMD
= 0.617, 95% CI 0.276 to 958, P<0.001), and emergence time (WMD = 0.997, 95% CI
0.392 to 1.561, P = 0.001). Further evidences are required to evaluate the
incidence of postoperative nausea and vomiting (PONV). Sensitivity analysis
strengthened evidences for lower incidences of EA, pain, and prolonged extubation
time, and emergence time. Funnel plots did not detect any significant publication
bias.
CONCLUSION: Meta-analysis demonstrated that dexmedetomidine decreased the
incidence of EA in children under sevoflurane anesthesia.
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