Effect of single-dose dexmedetomidine on the incidence of emergence delirium after sevoflurane-based anesthesia in children undergoing strabismus surgery

Elghamry, Mona Raafat; Elkeblawy, Amira Mahfouz

doi:10.1080/11101849.2020.1863309

Cited by 9 publications

(23 citation statements)

References 29 publications

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“…If the score was >3, morphine was administered intravenously as rescue analgesia with dose of 25 ug kg -1 [ 19 ]. In addition, 0.1 mg kg -1 ondansetron was given intravenously as an antiemetic to all the patients in both groups postoperatively [ 12 , 15 , 17 ] (Tables 1 and 2 ; Figs. 2 and 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, the premedication time was not always controlled, which may impact the drug effects [ 12 ]. Moreover, there was no long-term follow-up of patients diagnosed with ED [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patient characteristics were thoroughly examined for all eight included studies [12][13][14][15][16][17][18][19], which were all prospective, double-blinded, parallel-group and singlecentre RCTs. They were published in 2020 (n= 4), 2021 (n= 2) or 2022 (n= 2) and were all national studies conducted in China (n=3), India (n=2), Indonesia (n=1), Egypt (n=1) and Qatar (n=1).…”

Section: Study Characteristics Included Studiesmentioning

confidence: 99%

“…Participant ages were between 2 months and 14 years and were more often male (n=329; 52%) than female (n=300; 48%). In seven studies, dexmedetomidine was given preoperatively [12][13][14][15][16][17]19], and in one study, it was given postoperatively [18]. Dexmedetomidine was administered intranasally in five studies [12-14, 17, 19] and intravenously in three studies [15,16,18].…”

Section: Study Characteristics Included Studiesmentioning

confidence: 99%

“…In seven studies, dexmedetomidine was given preoperatively [12][13][14][15][16][17]19], and in one study, it was given postoperatively [18]. Dexmedetomidine was administered intranasally in five studies [12-14, 17, 19] and intravenously in three studies [15,16,18].…”

Section: Study Characteristics Included Studiesmentioning

confidence: 99%

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The efficacy and safety of dexmedetomidine in preventing emergence delirium in paediatric patients following ophthalmic surgery: a systematic review and meta-analysis of randomised controlled trials

Alassaf

Sobahi

Alshahrani

2022

J Anesth Analg Crit Care

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Background The leading cause of emergence delirium (ED) in children postoperatively is the exposure to inhalational anaesthetics. ED can occur immediately after waking from anaesthesia, making patients generally uncooperative and agitated. Dexmedetomidine has sedative and analgesic effects and helps to reduce agitation and delirium and improve hemodynamic stability and the recovery of respiratory function; in addition to decreasing pain intensity, it is also well known for helping reduce nausea and vomiting. Objectives This updated systematic review meta-analysis investigate and summarise currently available evidence on the use of dexmedetomidine to prevent ED, reduce postoperative nausea and vomiting (PONV) and decrease the need for rescue analgesia in paediatric patients undergoing ophthalmic surgery. Methods The medical databases EMBASE, PubMed and Cochrane Library were searched for randomised controlled trials published between January 2020 and August 2022 that used Dexmedetomidine in paediatric patients undergoing ophthalmic surgery. The protocol was prospectively registered with PROSPERO (CRD42022343622). The review was accomplished according to the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’, and the meta-analysis was conducted by using RevMan5.4. These studies examine the efficacy of dexmedetomidine in preventing ED in children undergo ophthalmic surgery. The Cochrane ROB-1 was used to assess risk of bias (ROB). Results Eight studies comprised of 629 participants, of which 315 received dexmedetomidine and 314 placebos were examined. PAED score identified ED following surgery. A review and meta-analysis indicated that dexmedetomidine reduces ED incidence (RR = 0.39; 95% CI 0.25–0.62). Similarly, it reduces the use of rescue analgesia (RR = 0.38; 95% CI 0.25–0.57). However, dexmedetomidine did not help prevent PONV since no difference was found between groups (RR = 0.33; 95% CI 0.21–0.54). Conclusion This review showed that dexmedetomidine helped to reduce ED incidence in paediatric patients after ophthalmic surgery and reduced the need for rescue analgesia compared to placebo or other medications.

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Section: Resultsmentioning

confidence: 99%

“…However, the premedication time was not always controlled, which may impact the drug effects [ 12 ]. Moreover, there was no long-term follow-up of patients diagnosed with ED [ 15 ].…”

Section: Discussionmentioning

confidence: 99%