IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0240553.html
   My bibliography  Save this article

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

Author

Listed:
  • Fu-Wei Chiang
  • Jin-Lin Chang
  • Shih-Chang Hsu
  • Kuo-Yuan Hsu
  • Karen Chia-Wen Chu
  • Chun-Jen Huang
  • Chyi-Huey Bai
  • Chiehfeng Chen
  • Chin-Wang Hsu
  • Yuan-Pin Hsu

Abstract

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): 0.39; 95% confidence interval (CI): 0.25–0.62, I2 = 66%], severe EA incidence (RR: 0.27, 95% CI: 0.17–0.43, I2 = 0%), PONV incidence (RR: 0.33, 95% CI: 0.21–0.54, I2 = 0%), analgesia requirement (RR: 0.38, 95% CI: 0.25–0.57, I2 = 0%), and pain scores (standardized mean difference: −1.02, 95% CI: −1.44 to −0.61, I2 = 75%). Dexmedetomidine also led to lower EA incidence in the sevoflurane group than in the desflurane group (RR: 0.26 for sevoflurane vs. 0.45 for desflurane). Continuous dexmedetomidine infusion (RR: 0.19) led to better EA incidence reduction than did bolus dexmedetomidine infusion at the end of surgery (RR: 0.26) or during the peri-induction period (RR: 0.36). Compared with placebo use, dexmedetomidine use reduced OCR incidence (RR: 0.63; I2 = 40%). No significant between-group differences were noted for PACU stay duration. Conclusion: In patients who have undergone pediatric strabismus surgery, dexmedetomidine use may alleviate EA, PONV, and postoperative pain and reduce OCR incidence. Moreover, dexmedetomidine use does not affect the PACU stay duration.

Suggested Citation

  • Fu-Wei Chiang & Jin-Lin Chang & Shih-Chang Hsu & Kuo-Yuan Hsu & Karen Chia-Wen Chu & Chun-Jen Huang & Chyi-Huey Bai & Chiehfeng Chen & Chin-Wang Hsu & Yuan-Pin Hsu, 2020. "Dexmedetomidine use in pediatric strabismus surgery: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    • Handle: RePEc:plo:pone00:0240553
    DOI: 10.1371/journal.pone.0240553
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240553
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0240553&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0240553?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Juan Ni & Jiafu Wei & Yusheng Yao & Xiaoqin Jiang & Linli Luo & Dong Luo, 2015. "Effect of Dexmedetomidine on Preventing Postoperative Agitation in Children: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      More about this item

      Statistics

      Access and download statistics

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0240553. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.