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Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis
Author(s) -
Hwang Se Hwan,
Lee Ho Seok,
Joo Young Hoon,
Seo Jae Hyun,
Kang Jun Myung
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26787
Subject(s) - dexmedetomidine , medicine , anesthesia , perioperative , bradycardia , postoperative nausea and vomiting , vomiting , sedation , adverse effect , analgesic , nausea , sedative , heart rate , blood pressure
Objectives The goal of this meta‐analysis was to perform a systematic review of the literature on the effect of dexmedetomidine on perioperative morbidity following nasal surgery and on the adverse effects of dexmedetomidine. Data Sources MEDLINE, Scopus, and Cochrane Database of Systematic Reviews. Review Methods Two authors independently searched scientific and medical databases from their inception of article collection to March 2017. Studies that compared perioperative dexmedetomidine administration (dexmedetomidine group) with another agent under monitored anesthesia care (MAC) or general anesthesia (control group) with outcomes of interest that were perioperative pain intensity; rescue analgesic consumption; or adverse effects such as hemodynamic instability, nausea, and vomiting (PONV), and operative bleeding were included in the analysis. Results Perioperative pain scores and postoperative need for analgesics were significantly decreased in the dexmedetomidine group versus control group (other agent or general anesthesia). In subgroup analysis according to anesthesia type (general anesthesia and other sedatives in MAC), dexmedetomidine showed a similar effect on bradycardia, hypotension, and desaturation with general anesthesia, but it reduced PONV effectively compared with general anesthesia. Additionally, dexmedetomidine satisfied patient significantly. By contrast, compared with other sedative under MAC, it provoked bradycardia significantly. Conclusion This meta‐analysis showed that systemic administration of dexmedetomidine efficiently can decrease intraoperative and postoperative pain without adverse effects such as nausea, vomiting, and respiratory depression. Dexmedetomidine also can decrease analgesic consumption. However, clinicians should be aware of the potential for intraoperative bradycardia; patients also should be educated regarding these possibilities. Level of Evidence NA. Laryngoscope , 128:573–580, 2018