Effects of Intravenous Dexmedetomidine on Emergence Agitation in Children Under Sevoflurane Anesthesia: a Meta-analysis of Randomized Controlled Trials

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Jun 17

PMID 24932765

Citations 17

Authors

Chengliang Zhang

Jiajia Hu

Xinyao Liu

Jianqin Yan

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Comparative Study of the Effect of Two Different Doses of Dexmedetomidine to Prevent Emergence Agitation in Tonsillectomy in Children Aged 2 to 12 Years Old.

Shahhosseini S, Naderi Boldaji H, Shetabi H, Shafa A Adv Biomed Res. 2023; 12:57.

PMID: 37200744 PMC: 10186030. DOI: 10.4103/abr.abr_30_21.

Effect of Dexmedetomidine in Sub-Tenon's Block on Emergence Agitation in Pediatric Strabismus Surgery under Sevoflurane Anesthesia.

El-Sherbiny S, Kamal R, Sadik N, Elshahat A Anesth Essays Res. 2022; 16(1):160-166.

PMID: 36249154 PMC: 9558671. DOI: 10.4103/aer.aer_99_22.

Effect of different administration and dosage of dexmedetomidine in the reduction of emergence agitation in children: a meta-analysis of randomized controlled trials with sequential trial analysis.

Zhang X, Bai Y, Shi M, Ming S, Jin X, Xie Y Transl Pediatr. 2021; 10(4):929-957.

PMID: 34012842 PMC: 8107879. DOI: 10.21037/tp-21-105.

Effects of Dexmedetomidine on Emergence Agitation and Recovery Quality Among Children Undergoing Surgery Under General Anesthesia: A Meta-Analysis of Randomized Controlled Trials.

Yang X, Hu Z, Peng F, Chen G, Zhou Y, Yang Q Front Pediatr. 2020; 8:580226.

PMID: 33304867 PMC: 7694572. DOI: 10.3389/fped.2020.580226.

Comparison of single minimum dose administration of dexmedetomidine and midazolam for prevention of emergence delirium in children: a randomized controlled trial.

Cho E, Cha Y, Shim J, Ahn J, Lee S, Ryu K J Anesth. 2019; 34(1):59-65.

PMID: 31701308 DOI: 10.1007/s00540-019-02705-6.

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