Abstract | BACKGROUND: METHODS: This meta-analysis was performed according to the recommendations of the PRISMA statement and the Cochrane collaboration. For dichotomous and continuous outcomes of efficacy and adverse events, the Revman(®) (The Nordic Cochrane Centre, Copenhagen, Denmark) statistical software was used to calculate relative risk (RR), mean difference (MD), and 95% confidence intervals (CI). RESULTS: We included 11 randomized controlled trials - 434 children received dexmedetomidine, 440 received control. In comparison with placebo, children receiving dexmedetomidine showed a reduced RR for postoperative opioids (0.4; 95% CI: 0.26-0.62; P < 0.00001) and postoperative pain (0.51; 95% CI: 0.32-0.81; P = 0.004). Similar results were obtained for the comparison with intraoperative opioids: reduced RR for postoperative pain (0.49; 95% CI: 0.25-0.94; P = 0.03) and the need for postoperative opioids (0.77; 95% CI: 0.60-1.09; P = 0.05). CONCLUSIONS: This meta-analysis revealed a lower risk for postoperative pain and the need for postoperative opioids following intraoperative dexmedetomidine in comparison with placebo or opioids in children undergoing surgery; however, the influence of dexmedetomidine on postoperative opioid consumption is less clear. Although there were only a limited number of adverse events, further studies focusing on procedure specific dexmedetomidine dosing and adverse events are urgently needed.
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Authors | Alexander Schnabel, Sylvia U Reichl, Daniel M Poepping, Peter Kranke, Esther M Pogatzki-Zahn, Peter K Zahn |
Journal | Paediatric anaesthesia
(Paediatr Anaesth)
Vol. 23
Issue 2
Pg. 170-9
(Feb 2013)
ISSN: 1460-9592 [Electronic] France |
PMID | 23043461
(Publication Type: Journal Article, Meta-Analysis, Review)
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Copyright | © 2012 Blackwell Publishing Ltd. |
Chemical References |
- Analgesics, Non-Narcotic
- Analgesics, Opioid
- Dexmedetomidine
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Topics |
- Airway Extubation
- Analgesics, Non-Narcotic
(adverse effects, therapeutic use)
- Analgesics, Opioid
(administration & dosage, therapeutic use)
- Child
- Child, Preschool
- Confidence Intervals
- Critical Care
- Dexmedetomidine
(adverse effects, therapeutic use)
- Humans
- Infant
- Infant, Newborn
- Length of Stay
- Pain, Postoperative
(drug therapy)
- Psychomotor Agitation
(epidemiology)
- Randomized Controlled Trials as Topic
- Risk Assessment
- Treatment Outcome
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