Effects of dexmedetomidine on postoperative recovery profile after sevoflurane anesthesia in pediatric patients: A meta-analysis

Abstract

Objective: We aim to evaluate whether dexmedetomidine can reduce incidence caused by sevoflurane anesthesia in pediatric patients systematically. Methods: We have searched the Cochrane Library, PubMed, EBSCO, Springer, Chinese Journal Full-text Database (CNKI), Chinese Biomedical Literature Database (CBM) and WanFang Data (all the materials selected from these databases range from the date of establishment of the databases to April 2013). Reference lists of all studies have also been checked. Two valuators performed the process of RCT, quality assessment, and data extraction with inclusion and exclusion criteria, and conduct the Meta-analysis with the software RevMan5.2. Results: The meta-analysis which including 27 randomized trials and 1882 children showed that dexmedetomidine extended the incidence of the children's recovery time [MD=2.39, 95% CI (1.27, 3.51)] and discharge time [MD=6.09, 95% CI (3.42, 8.77)] compared with placebo. Nevertheless, there were no obvious differences in extubation time [MD=0.75, 95% CI (0.45, 1.05)]. While reducing the incidence of early emergence agitation, dexmedetomidine showed a large advantage [RR=0.31, 95% CI (0.26, 0.38)] and could reduce agitation score [MD=-0.89, 95% CI (-1.04, -0.74)], also could reduce pain score [MD=-2.66, 95% CI (-3.81, -1.51)], as well as the need for painkillers [RR=0.34, 95% CI (0.22, 0.52)]. What's more, on reducing occurrence of nausea and vomiting [RR=0.59, 95% CI (0.36, 0.97)], occurrence of bucking [RR=0.39, 95% CI (0.23, 0.68)], dexmedetomidine also showed some preventive effects. There were no serious side effects on respiratory and circulatory system in all included studies. Conclusion: Dexmedetomidine can be used safely in children and improve the awakening quality after sevoflurane anesthesia. © 2013 Jin-hui C, et al.