Prophylactic application of dexmedetomidine reduces the incidence of emergence delirium in children: A systematic review and meta-analysis - 08/11/24
, Ming-yang Sun c, ⁎ Abstract |
Background |
Emergence delirium (ED) is a common postoperative cognitive dysfunction in children. ED may cause distress to patients and their families in the early post-anesthesia period and have long-term adverse effects on children.
The primary purpose |
was to verify whether dexmedetomidine can reduce the occurrence of ED in children.
Research type |
Systematic review and meta-analysis of RCTs.
Data acquisition |
A search was conducted on Web of Science, WHO Trials, Cochrane Library, Clinical Trials.gov, and PubMed for all published studies from inception to 23 Oct. 2022.
Eligibility criteria |
Randomized clinical trials that met the following criteria: patients aged 1–18 years, study site in the PACU (Post-anesthesia care unit), incidence of ED as the primary outcome, and prophylactic use of dexmedetomidine defined as injected before admission to the PACU.
Results |
A total of 7 randomized trials were included (6 studies during eye and neck surgery, 1 during hernia surgery), involving 512 patients (257 (50.1%) with dexmedetomidine, and 250 (49.9%) with control. ED was observed in 17.51% of the patients treated with dexmedetomidine and in 43.14% of those receiving control (risk ratio (RR) = 0.40, 95 % confidence interval [CI] [0.30−0.55], P < 0.00001). Additionally, the prophylactic application of dexmedetomidine also reduced the occurrence of Post-Operating Nausea and Vomiting (RR = 0.24, 95%CI [0.12−0.49], P = 0.0001) and PACU stay time after extubation (mean difference (MD) = −1.57, 95%CI [−3.07 to −0.07], P = 0.04). However, sensitivity analysis of RCTs showed that our effect estimates were not stable (MD = −1.78, 95%CI [−4.18−0.62], P = 0.15).
Conclusion |
The prophylactic use of dexmedetomidine was associated with a reduction of ED. However, our findings only apply to eye and neck surgery.
Trial registration |
PROSPERO: CRD42022371840.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Question: What is the effect of dexmedetomidine on emergence delirium in children undergoing eye and neck surgery? |
• | Findings: This meta-analysis, which enrolled 512 patients, found a lower incidence of emergence delirium among patients who received dexmedetomidine than among patients in the control group (17.51% vs. 43.14%, respectively). |
• | Meaning: The findings of this meta-analysis suggest that dexmedetomidine may be a reliable strategy for improving emergence delirium in children. |
Plan
Vol 43 - N° 6
Article 101426- décembre 2024 Retour au numéro
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