Xiao Liang1, Miao Zhou2, Jiao-Jiao Feng3, Liang Wu2, Shang-Ping Fang4, Xin-Yu Ge5, Hai-Jing Sun4, Peng-Cheng Ren6, Xin Lv7. 1. Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University China. 2. Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical College; Jiangsu Province Key Laboratory of Anesthesia, and Analgesia Application Technology, Xuzhou Medical College China. 3. Department of Medical Microbiology and Parasitology, School of Basic Medicine, Second Military Medical University China. 4. Department of Anesthesiology, Changzheng Hospital, The Second Military Medical University China. 5. Hebei North University School of Medicine China. 6. Department of Anesthesiology, Affiliated Tangdu Hospital of The Fourth Military Medical University China. 7. Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine China.
Abstract
PURPOSE: Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on PONV. METHODS: Two researchers independently searched PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs). The meta-analysis was performed with Review Manager. RESULTS: Eighty-two trials with 6,480 patients were included in this meta-analysis. Dexmedetomidine reduced postoperative nausea (Risk Ratio (RR) = 0.61, 95% confidence interval (CI): 0.50 to 0.73) and vomiting (RR = 0.48, 95% CI: 0.36 to 0.64) compared with placebo, with an effective dose of 0.5 μg/kg (RR = 0.46, 95% CI: 0.34 to 0.62) and 1.0 μg/kg (RR = 0.29, 95% CI: 0.12 to 0.75), respectively. The antiemetic effect can only be achieved intravenously, not epidurally or intrathecally. The efficacy of dexmedetomidine was similar to that of widely used agents, such as propofol, midazolam etc., but better than opioid analgesics. Moreover, application of dexmedetomidine reduced intraoperative requirement of fentanyl (Standard Mean Difference = -1.91, 95% CI: -3.20 to -0.62). CONCLUSIONS: The present meta-analysis indicates that dexmedetomidine shows superiority to placebo, but not to all other anesthetic agents on PONV. And this efficacy may be related to a reduced consumption of intraoperative opioids.
PURPOSE:Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on PONV. METHODS: Two researchers independently searched PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs). The meta-analysis was performed with Review Manager. RESULTS: Eighty-two trials with 6,480 patients were included in this meta-analysis. Dexmedetomidine reduced postoperative nausea (Risk Ratio (RR) = 0.61, 95% confidence interval (CI): 0.50 to 0.73) and vomiting (RR = 0.48, 95% CI: 0.36 to 0.64) compared with placebo, with an effective dose of 0.5 μg/kg (RR = 0.46, 95% CI: 0.34 to 0.62) and 1.0 μg/kg (RR = 0.29, 95% CI: 0.12 to 0.75), respectively. The antiemetic effect can only be achieved intravenously, not epidurally or intrathecally. The efficacy of dexmedetomidine was similar to that of widely used agents, such as propofol, midazolam etc., but better than opioid analgesics. Moreover, application of dexmedetomidine reduced intraoperative requirement of fentanyl (Standard Mean Difference = -1.91, 95% CI: -3.20 to -0.62). CONCLUSIONS: The present meta-analysis indicates that dexmedetomidine shows superiority to placebo, but not to all other anesthetic agents on PONV. And this efficacy may be related to a reduced consumption of intraoperative opioids.
Authors: Burcu Tufanogullari; Paul F White; Mariana P Peixoto; Daniel Kianpour; Thomas Lacour; James Griffin; Gary Skrivanek; Amy Macaluso; Mary Shah; David A Provost Journal: Anesth Analg Date: 2008-06 Impact factor: 5.108
Authors: HyunJeong Kwak; Young Jin Chang; Kyung Cheon Lee; Wol Seon Jung; Sunkoo Kwon; Youn Yi Jo Journal: J Int Med Res Date: 2019-09-11 Impact factor: 1.671