Wei-Guo Zhong1, Xin-Yu Ge2, Hai Zhu3, Xiao Liang4, Hong-Xia Gong5, Ming Zhong6, Xiang Xiao7. 1. Department of Obstetrics, Shanghai Changning District Maternity and Infant Health Hospital Changning District, Shanghai 200051, P. R. China. 2. Hebei North University, School of Medicine P. R. China ; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University Huangpu District, Shanghai 200003, P. R. China. 3. Department of Anesthesiology, Shanghai Putuo District Maternity and Children Healthcare Hospital P. R. China. 4. Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University P. R. China ; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University Huangpu District, Shanghai 200003, P. R. China. 5. Department of Obstetrics and Gynecology, Shanghai Putuo District Maternity and Children Healthcare Hospital P. R. China. 6. Department of Critical Care Medicine, Zhongshan Hospital, Fudan University P. R. China. 7. Section of Scientific Research Management, Changzheng Hospital, Second Military Medical University P. R. China.
Abstract
PURPOSE: Postoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries. METHODS: Three main electronic databases including Pub Med, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) were searched by two researchers independently. The metaanalysis was completed using Review Manager. RESULTS: Eleven RCTs with 692 patients were included in this metaanalysis. Dexmedetomidine a bridged postoperative nausea [Risk Ratio (RR)=0.59, 95% confidence interval (CI): 0.44 to 0.79] and vomiting [RR=0.48, 95% CI: 0.36 to 0.64] compared with placebo. Despite of higher incidence of intra operative bradycardia [RR 2.87, 95% CI 1.08 to 7.58] and hypotension [RR 4.26, 95% CI 1.43 to 12.69], we found significant decrease in postoperative shivering [RR 0.23, 95% CI 0.13 to 0.40] and pruritus [RR 0.40, 95% CI 0.17 to 0.93] in dexmedetomidine group, as well as the pain scores [standard mean difference (SMD)-0.96, 95% CI-1.37 to-0.54]. Significant reductions in the need for intraoperative fentanyl (RR 0.10, 95% CI 0.01-0.76, I(2) 0%), antiemetic (RR 0.62, 95% CI 0.39-0.99, I(2) 0%) and postoperative analgesic (RR 0.18, 95% CI 0.08-0.42, I(2) 0%) were also elicited. CONCLUSIONS: The current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.
PURPOSE:Postoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries. METHODS: Three main electronic databases including Pub Med, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) were searched by two researchers independently. The metaanalysis was completed using Review Manager. RESULTS: Eleven RCTs with 692 patients were included in this metaanalysis. Dexmedetomidine a bridged postoperative nausea [Risk Ratio (RR)=0.59, 95% confidence interval (CI): 0.44 to 0.79] and vomiting [RR=0.48, 95% CI: 0.36 to 0.64] compared with placebo. Despite of higher incidence of intra operative bradycardia [RR 2.87, 95% CI 1.08 to 7.58] and hypotension [RR 4.26, 95% CI 1.43 to 12.69], we found significant decrease in postoperative shivering [RR 0.23, 95% CI 0.13 to 0.40] and pruritus [RR 0.40, 95% CI 0.17 to 0.93] in dexmedetomidine group, as well as the pain scores [standard mean difference (SMD)-0.96, 95% CI-1.37 to-0.54]. Significant reductions in the need for intraoperative fentanyl (RR 0.10, 95% CI 0.01-0.76, I(2) 0%), antiemetic (RR 0.62, 95% CI 0.39-0.99, I(2) 0%) and postoperative analgesic (RR 0.18, 95% CI 0.08-0.42, I(2) 0%) were also elicited. CONCLUSIONS: The current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.
Authors: Islam M Massad; Wafa A Mohsen; Asma S Basha; Khaled R Al-Zaben; Mahmoud M Al-Mustafa; Subhi M Alghanem Journal: Saudi Med J Date: 2009-12 Impact factor: 1.484
Authors: Yuwen Chen; Yiziting Zhu; Kunhua Zhong; Zhiyong Yang; Yujie Li; Xin Shu; Dandan Wang; Peng Deng; Xuehong Bai; Jianteng Gu; Kaizhi Lu; Ju Zhang; Lei Zhao; Tao Zhu; Ke Wei; Bin Yi Journal: Front Med (Lausanne) Date: 2022-09-14