Systematic review and meta-analysis of the sedative effects and safety of dexmedetomidine in patients after cardiac surgery

Abstract

Background: In order to increase the sample size and improve the test efficiency from a statistical perspective, we conducted a combined analysis of multiple results from similar studies. In this study, we conducted a meta-analysis to investigate the sedative effect of dexmedetomidine on patients after cardiac surgery, so as to provide theoretical basis and help for clinical treatment of cardiac diseases. Methods: The Boolean logic search method was employed to search online databases for publications, with “dexmedetomidine”, “cardiac surgery”, “competitive antagonist”, and “analgesic sedation” used as keywords. In addition, the literature was screened for comparative studies on the use of midazolam and propofol as controls. The Newcastle-Ottawa Scale (NOS) of Cochrane Collaborative Network was used to evaluate the pathological control studies in Meta-analysis, and the star rating system (out of 9 stars) was used to measure the results from the subjects, cases and groups. Finally, a meta-analysis was performed with Review Manager software (Cochrane). Results: Thirteen references containing mostly low-risk biases (medium-high quality) were included in this study. The meta-analysis showed no statistically obvious heterogeneity in the mechanical ventilation time (MVT) between patients in the control group (group A) or patients in the experimental group (group B) (Chi2=74.71; I2=92%; P<0.00001), showing no statistical significance (Z=1.57; P=0.12). Heterogeneity was found as a complication in both groups (Chi2=14.82; I2=60%; P=0.02), but fewer complications were observed in group B (Z=2.06, P=0.04). The sedative effect displayed by patients from the 2 groups during the induction of anesthesia was statistically heterogeneous (Chi2=6.45; I2=38%; P=0.17), but the sedative effect in group B was shown to be greater (Z=3.31, P=0.0009). Conclusions: Dexmedetomidine can significantly reduce the mechanical ventilation time and the incidence of complications in patients after cardiac surgery, and has a high safety and good sedative effect on patients.