Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane: a meta-analysis

Amorim, Marco Aurélio Soares; Govêia, Cátia Sousa; Magalhães, Edno; Ladeira, Luis Cláudio Araújo; Moreira, Larissa Govêia; Miranda, Denismar Borges de

doi:10.1016/j.bjane.2016.02.007

Cited by 19 publications

(30 citation statements)

References 30 publications

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“…In addition, the incidence of nausea and vomiting associated with sevoflurane anaesthesia is reported to be as high as 30%. 40 The present meta-analysis showed that the incidence of nausea and vomiting was significantly lower in the Dex group than in the placebo group, and these results were similar to those reported in the metaanalysis by Amorim et al 10 The results of the present study may be limited by several factors. The metaanalysis mainly included publications in English, as there were few studies in other languages, and some valuable studies may have been ignored.…”

Section: Discussionsupporting

confidence: 91%

“…[4][5][6][7][8][9][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The results showed that, compared with placebo, Dex was associated with positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane, reducing nausea and vomiting and shortening the eye-opening time, extubation time, and duration of PACU stay. Unlike the present study, Amorim et al 10 reported that Dex reduced the incidence of emergence agitation while prolonging the duration of PACU stay and eye-opening time. A potential explanation for this discrepancy is that the meta-analysis reported by Amorim et al 10 only screened one database, so that only a limited number of publications were included; additionally, the sample size was relatively small.…”

Section: Discussioncontrasting

confidence: 85%

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Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Wen

Liu

2020

J Int Med Res

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Objective The sedative effects of dexmedetomidine (Dex) are similar to natural sleep, with easy wakening following Dex administration, and Dex has minor effects on breathing, reducing emergence agitation in children. The aim of this study was to systematically evaluate the effects of Dex on recovery quality in children following general anaesthesia with sevoflurane, to aid clinical decision making. Methods Relevant randomized controlled trials published before August 2019 were searched and selected from databases. Two researchers independently screened the literature, extracted data, and assessed included studies for bias risk. Meta-analysis was performed using Stata 14.0 software. Results The study included 24 publications. Following general anaesthesia by sevoflurane, Dex was associated with reduced occurrence of emergence agitation (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.11, 0.25) and nausea and vomiting (OR 0.40, 95% CI 0.24, 0.60), along with shortened eye-opening time (standardized mean difference [SMD] 0.72, 95% CI 0.41, 1.03), shortened extubation time (SMD 0.54, 95% CI 0.28, 0.81), and reduced duration of post-anaesthesia care unit (PACU) stay (SMD 0.29, 95% CI 0.08, 0.51) versus placebo. Conclusion Dexmedetomidine has positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 85%

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Wen

Liu

2020

J Int Med Res

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“…Our findings demonstrated that dexmedetomidine use reduced EA incidence in children receiving either sevoflurane or desflurane. A meta-analysis [29] indicated that compared with placebo use, dexmedetomidine use reduced sevoflurane-induced EA incidence in children. Nevertheless, the differences in EA incidence between children receiving sevoflurane and desflurane remained unclear [30,31].…”

Section: Plos Onementioning

confidence: 99%

Dexmedetomidine use in pediatric strabismus surgery: A systematic review and meta-analysis

et al. 2020

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Background Common complications of pediatric strabismus surgery, including emergence agitation (EA), postoperative nausea and vomiting (PONV), and postoperative pain, may be prevented using dexmedetomidine, which is an anxiolytic and analgesic. This systematic review and meta-analysis assessed the effects of dexmedetomidine in patients who had undergone pediatric strabismus surgery. Method Five databases were searched for randomized controlled trials published from database inception to April 2020 that compared dexmedetomidine use with placebo or active comparator use and evaluated EA, PONV, or postoperative pain incidence (main outcomes) in patients who had undergone pediatric strabismus surgery. Oculocardiac reflex (OCR) incidence and postanesthesia care unit (PACU) stay duration were considered as safety outcomes. All meta-analyses were performed using a random-effects model. Results In the nine studies meeting our inclusion criteria, compared with placebo use, dexmedetomidine use reduced EA incidence [risk ratio (RR): 0.

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“…Sevoflurane provides adequate muscle relaxation for intubation following inhalation induction. Moreover, contrary to the other halothanes, it does not depress myocardial contractility in children (11)(12). We as well used sevoflurane, which is recommended most in childhood in the literature, for the maintenance of anesthesia following induction in both groups.…”

Section: Discussionmentioning

confidence: 99%

Pediatrik Ambulatuar Cerrahi Hastaların Sünnet Operasyonlarında Remifentanil-Propofole karşı Fentanil Propofol

Baş

2018

Osmangazi̇ Journal of Medicine

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Circumcision is the most frequent surgical procedure performed worldwide. The present study aimed to compare the efficacy and safety of fentanyl vs. remifentanil in pediatric patients undergoing circumcision procedure. A total of 120 boys, who were ASA (American Society of Anesthesiologists) I-II and underwent circumcision procedure, were retrospectively evaluated. Induction for anesthesia was provided using propofol that using 0,5-1 μg kg-1 (n=60) in Group F and using remifentanil 0,5-1 μg kg-1 (n=60) in Group R. After monitoring the patients and recording hemodynamic parameters and complications the findings every 30 minutes in peroperative and the recovery room, the patients were then followed for 6 hours. A total of 120 boys at the age of 0-2 years old who were underwent circumcision procedure, were retrospectively evaluated. The groups were comparable in terms of age, body weight, height, ASA physical status and duration of surgery that was not statistically significant.Recovery time from anesthesia was statistically significantly shorter in the remifentanil-propofol (Group R) as compared to the fentanyl-propofol (Group F). While vomiting was the most common complication in Group F, bradycardia was the most common complication in Group R. Comparison of the frequencies of complications between the groups revealed no difference in terms of bradycardia, bronchospasm, respiratory depression and allergic reaction. In conclusion, based on the results of the present study, we recommend using remifentanil-propofol in this pediatric age group but also underline the necessity of close monitoring of these patients for the potential side effects.

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Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane: a meta-analysis

Abstract: Dexmedetomidine reduces psychomotor agitation during wake-up time of children undergoing general anesthesia with sevoflurane.

Cited by 19 publications

References 30 publications

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Dexmedetomidine use in pediatric strabismus surgery: A systematic review and meta-analysis

Pediatrik Ambulatuar Cerrahi Hastaların Sünnet Operasyonlarında Remifentanil-Propofole karşı Fentanil Propofol

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