Effects of peri-operative intravenous administration of dexmedetomidine on emergence agitation after general anesthesia in adults: a meta-analysis of randomized controlled trials

References

• Pickard A, Davies P, Birnie K, Beringer R. Systematic review and meta-analysis of the effect of intraoperative alpha(2)-adrenergic agonists on postoperative behaviour in children. Br J Anaesth. 2014;112(6):982–990. doi:10.1093/bja/aeu09324727829
   PubMed Web of Science ®Google Scholar
• Kim DJ, Kim SH, So KY, Jung KT. Effects of dexmedetomidine on smooth emergence from anaesthesia in elderly patients undergoing orthopaedic surgery. BMC Anesthesiol. 2015;15:139. doi:10.1186/s12871-015-0044-626446479
   PubMed Web of Science ®Google Scholar
• Eckenhoff JE, Kneale DH, Dripps RD. The incidence and etiology of postanesthetic excitment. A clinical survey. Anesthesiology. 1961;22:667–673. doi:10.1097/00000542-196109000-0000213889092
   PubMed Web of Science ®Google Scholar
• Munk L, Andersen G, Moller AM. Post-anaesthetic emergence delirium in adults: incidence, predictors and consequences. Acta Anaesthesiol Scand. 2016;60(8):1059–1066. doi:10.1111/aas.1271726968337
   PubMed Web of Science ®Google Scholar
• Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post-anaesthesia care unit. Br J Anaesth. 2006;96(6):747–753. doi:10.1093/bja/ael09416670111
   PubMed Web of Science ®Google Scholar
• Yu D, Chai W, Sun X, Yao L. Emergence agitation in adults: risk factors in 2,000 patients. Can J Anaesth. 2010;57(9):843–848. doi:10.1007/s12630-010-9338-920526708
   PubMed Web of Science ®Google Scholar
• Sharma PT, Sieber FE, Zakriya KJ, et al. Recovery room delirium predicts postoperative delirium after hip-fracture repair. Anesth Analg. 2005;101(4):1215–1220. doi:10.1213/01.ane.0000167383.44984.e516192548
   PubMed Web of Science ®Google Scholar
• Radtke FM, Franck M, MacGuill M, et al. Duration of fluid fasting and choice of analgesic are modifiable factors for early postoperative delirium. Eur J Anaesthesiol. 2010;27(5):411–416. doi:10.1097/EJA.0b013e3283335cee19887950
   PubMed Web of Science ®Google Scholar
• Kanaya A. Emergence agitation in children: risk factors, prevention, and treatment. J Anesth. 2016;30(2):261–267. doi:10.1007/s00540-015-2098-526601849
   PubMed Web of Science ®Google Scholar
• Kwak KH. Emergence agitation/delirium: we still don’t know. Korean J Anesthesiol. 2010;59(2):73–74. doi:10.4097/kjae.2010.59.2.7320740209
   PubMedGoogle Scholar
• Gerlach AT, Murphy CV, Dasta JF. An updated focused review of dexmedetomidine in adults. Ann Pharmacother. 2009;43(12):2064–2074. doi:10.1345/aph.1M31019934395
   PubMed Web of Science ®Google Scholar
• Afonso J, Reis F. Dexmedetomidine: current role in anesthesia and intensive care. Braz J Anesthesiol. 2012;62(1):118–133. doi:10.1016/S0034-7094(12)70110-1
   Google Scholar
• Fang X-Z, Gao J, Ge Y-L, Zhou L-J, Zhang Y. Network meta-analysis on the efficacy of dexmedetomidine, midazolam, ketamine, propofol, and fentanyl for the prevention of sevoflurane-related emergence agitation in children. Am J Ther. 2016;23(4):e1032–e1042. E1032–E1042. doi:10.1097/MJT.0000000000000321
   Web of Science ®Google Scholar
• Liu X, Xie G, Zhang K, et al. Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: a meta-analysis with trial sequential analysis of randomized controlled trials. J Crit Care. 2016;38:190–196. doi:10.1016/j.jcrc.2016.10.02627936404
   PubMed Web of Science ®Google Scholar
• Aldecoa C, Bettelli G, Bilotta F, et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34(4):192–214. doi:10.1097/EJA.000000000000059428187050
   PubMed Web of Science ®Google Scholar
• Lee HS, Yoon HY, Jin HJ, Hwang SH. Can dexmedetomidine influence recovery profiles from general anesthesia in nasal surgery? Otolaryngol Head Neck Surg. 2018;158(1):43–53. doi:10.1177/019459981773373528949804
   PubMed Web of Science ®Google Scholar
• Ham SY, Kim JE, Park C, Shin MJ, Shim YH. Dexmedetomidine does not reduce emergence agitation in adults following orthognathic surgery. Acta Anaesthesiol Scand. 2014;58(8):955–960. doi:10.1111/aas.1237925132201
   PubMed Web of Science ®Google Scholar
• Yang X, Li Z, Gao C, Liu R. Effect of dexmedetomidine on preventing agitation and delirium after microvascular free flap surgery: a randomized, double-blind, control study. J Oral Maxillofac Surg. 2015;73(6):1065–1072. doi:10.1016/j.joms.2015.01.01125981836
   PubMed Web of Science ®Google Scholar
• Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Br Med J (Clin Res Ed). 2009;339:b2700. doi:10.1136/bmj.b2651
   PubMed Web of Science ®Google Scholar
• Moller AM, Myles PS. What makes a good systematic review and meta-analysis? Br J Anaesth. 2016;117(4):428–430. doi:10.1093/bja/aew26428077528
   PubMed Web of Science ®Google Scholar
• Higgins, JPT GS Cochrane handbook for systematic reviews of interventions version 5.1.0. cochrane collaboration, 2011 Available from: http://handbookcochraneorg. Accessed 725, 2016.
   Google Scholar
• Higgins JP, Altman DG, Gotzsche PC, et al. The cochrane collaboration’s tool for assessing risk of bias in randomised trials. Br Med J (Clin Res Ed). 2011;343:d5928. doi:10.1136/bmj.d5928
   PubMed Web of Science ®Google Scholar
• DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28(2):105–114. doi:10.1016/j.cct.2006.04.00416807131
   PubMed Web of Science ®Google Scholar
• Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–1558. doi:10.1002/sim.118612111919
   PubMed Web of Science ®Google Scholar
• Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J (Clin Res Ed). 2003;327(7414):557–560. doi:10.1136/bmj.327.7414.557
   PubMed Web of Science ®Google Scholar
• Brok J, Thorlund K, Gluud C, Wetterslev J. Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta-analyses. J Clin Epidemiol. 2008;61(8):763–769. doi:10.1016/j.jclinepi.2007.10.00718411040
   PubMed Web of Science ®Google Scholar
• Thorlund K, Engstrøm J, Wetterslev J, et al. User Manual for Trial Sequential Analysis (TSA). Copenhagen: Denmark Copenhagen Trial Unit, Cent Clin Interv Res;2011 Availbale from: wwwctudk/tsa. Accessed 112, 2015.
   Google Scholar
• van der Tweel I, Bollen C. Sequential meta-analysis: an efficient decision-making tool. Clin Trials. 2010;7(2):136–146. doi:10.1177/174077450936099420338906
   PubMed Web of Science ®Google Scholar
• Wetterslev J, Thorlund K, Brok J, Gluud C. Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. J Clin Epidemiol. 2008;61(1):64–75. doi:10.1016/j.jclinepi.2007.03.01318083463
   PubMed Web of Science ®Google Scholar
• Wetterslev J, Thorlund K, Brok J, Gluud C. Estimating required information size by quantifying diversity in random-effects model meta-analyses. BMC Med Res Methodol. 2009;9:86. doi:10.1186/1471-2288-9-8620042080
   PubMed Web of Science ®Google Scholar
• Sterne JAC. Meta-Analysis in Stata: An Updated Collection from the Stata Journal. Texas: Stata Press; 2008:242–254.
   Google Scholar
• Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Br Med J (Clin Res Ed). 1997;315(7109):629–634. doi:10.1136/bmj.315.7109.629
   PubMed Web of Science ®Google Scholar
• Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61(10):991–996. doi:10.1016/j.jclinepi.2007.11.01018538991
   PubMed Web of Science ®Google Scholar
• Harbord RM, Higgins JPT. Meta-regression in Stata. Stata J. 2008;8(4):493–519. doi:10.1177/1536867X0800800403
   Web of Science ®Google Scholar
• Dechartres A, Altman DG, Trinquart L, Boutron I, Ravaud P. Association between analytic strategy and estimates of treatment outcomes in meta-analyses. Jama. 2014;312(6):623–630. doi:10.1001/jama.2014.816625117131
   PubMed Web of Science ®Google Scholar
• Kim SY, Kim JM, Lee JH, Song BM, Koo BN. Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery. Br J Anaesth. 2013;111(2):222–228. doi:10.1093/bja/aet05623524149
   PubMed Web of Science ®Google Scholar
• Jung JW, Kim YH, Lee KH, et al. Effect of dexmedetomidine on emergence agitation in male patients undergoing closed reduction of a nasal bone fracture. RMJ. 2015;40(2):191–196.
   Google Scholar
• Polat R, Peker K, Baran I, Bumin Aydin G, Topcu Guloksuz C, Donmez A. Comparison between dexmedetomidine and remifentanil infusion in emergence agitation during recovery after nasal surgery: a randomized double-blind trial. BMC Anesthesiol. 2015;64(10):740–746.
   Google Scholar
• Kwon SY, Joo JD. Effects of dexmedetomidine infusion on the recovery profiles of patients undergoing transurethral resection. J Korean Med Sci. 2016;31(1):125–130. doi:10.3346/jkms.2016.31.1.12526770048
   PubMed Web of Science ®Google Scholar
• Lee SH, Lee CY, Lee JG, Kim N, Lee HM, Oh YJ. Intraoperative dexmedetomidine improves the quality of recovery and postoperative pulmonary function in patients undergoing video-assisted thoracoscopic surgery: a CONSORT-prospective, randomized, controlled trial. Medicine. 2016;95(7):e2854. doi:10.1097/MD.000000000000486426886651
   PubMed Web of Science ®Google Scholar
• Li Y, Wang B, Zhang LL, et al. Dexmedetomidine combined with general anesthesia provides similar intraoperative stress response reduction when compared with a combined general and epidural anesthetic technique. Anesth Analg. 2016;122(4):1202–1210. doi:10.1213/ANE.000000000000116526991622
   PubMed Web of Science ®Google Scholar
• Xu K, Pan Y, Zhu M. Effects of dexmedetomidine on the recovery profiles from general anesthesia in patients undergoing endoscopic sinus surgery. Int J Clin Exp Med. 2016;9(5):8405–8410.
   Web of Science ®Google Scholar
• Khurshid DH, Muneer DK, Sadiq Malla M. Effect of dexmedetomidine on emergence agitation after nasal surgeries. Med Sci Clin Res. 2015;3(9):7527–7531.
   Google Scholar
• Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13. doi:10.1186/1471-2288-5-2715840177
   PubMedGoogle Scholar
• Moore AD, Anghelescu DL. Emergence delirium in pediatric anesthesia. Paediatr Drugs. 2017;19(1):11–20. doi:10.1007/s40272-016-0201-527798810
   PubMed Web of Science ®Google Scholar
• Maze M, Scarfini C, Cavaliere F. New agents for sedation in the intensive care unit. Crit Care Clin. 2001;17(4):881–897.11762266
   PubMed Web of Science ®Google Scholar
• Djaiani G, Silverton N, Fedorko L, et al. Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery: a randomized controlled trial. Anesthesiology. 2016;124(2):362–368. doi:10.1097/ALN.000000000000095126575144
   PubMed Web of Science ®Google Scholar
• Reade MC, Eastwood GM, Bellomo R, et al. Effect of dexmedetomidine added to standard care on ventilator-free time in patients with agitated delirium: a randomized clinical trial. Jama. 2016;315(14):1460–1468. doi:10.1001/jama.2016.270726975647
   PubMed Web of Science ®Google Scholar
• Su X, Meng ZT, Wu XH, et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. Lancet. 2016;388(10054):1893–1902. doi:10.1016/S0140-6736(16)30580-327542303
   PubMed Web of Science ®Google Scholar
• Kosar CM, Tabloski PA, Travison TG, et al. Effect of preoperative pain and depressive symptoms on the development of postoperative delirium. Lancet Psychiatry. 2014;1(6):431–436. doi:10.1016/S2215-0366(14)00006-625642413
   PubMed Web of Science ®Google Scholar
• Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology. 2003;98(2):428–436. doi:10.1097/00000542-200302000-0002412552203
   PubMed Web of Science ®Google Scholar
• Wu XH, Cui F, Zhang C, et al. Low-dose dexmedetomidine improves sleep quality pattern in elderly patients after noncardiac surgery in the intensive care unit: a pilot randomized controlled trial. Anesthesiology. 2016;125(5):979–991. doi:10.1097/ALN.000000000000132527571256
   PubMed Web of Science ®Google Scholar
• Coull JT, Jones ME, Egan TD, Frith CD, Maze M. Attentional effects of noradrenaline vary with arousal level: selective activation of thalamic pulvinar in humans. NeuroImage. 2004;22(1):315–322. doi:10.1016/j.neuroimage.2003.12.02215110021
   PubMed Web of Science ®Google Scholar
• Jo YY, Kim HS, Lee KC, Chang YJ, Shin Y, Kwak HJ. Consort the effect of intraoperative dexmedetomidine on hemodynamic responses during emergence from nasotracheal intubation after oral surgery. Medicine. 2017;96(16):e6661. doi:10.1097/MD.000000000000666128422874
   PubMed Web of Science ®Google Scholar
• OB H, Mohan H, Hare CO, Reynolds JV, Kenny RA. Mind over matter? The hidden epidemic of cognitive dysfunction in the older surgical patient. Ann Surg. 2017;265(4):677–691. doi:10.1097/SLA.000000000000190027537541
   PubMed Web of Science ®Google Scholar
• Kim HJ, Kim DK, Kim HY, Kim JK, Choi SW. Risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery. Clin Exp Otorhinolaryngol. 2015;8(1):46–51. doi:10.3342/ceo.2015.8.1.4625729495
   PubMed Web of Science ®Google Scholar
• Aouad MT, Zeeni C, Al Nawwar R, et al. Dexmedetomidine for improved quality of emergence from general anesthesia: a dose-finding study. Anesth Analg. 2017. doi:10.1213/ANE.0000000000002763
   PubMed Web of Science ®Google Scholar
• Tan Y, Shi Y, Ding H, Kong X, Zhou H, Tian J. Mu-Opioid agonists for preventing emergence agitation under sevoflurane anesthesia in children: a meta-analysis of randomized controlled trials. Paediatr Anaesth. 2016;26(2):139–150. doi:10.1111/pan.1281526614352
   PubMed Web of Science ®Google Scholar
• Sedgwick P. Meta-analysis: testing for reporting bias. Br Med J (Clin Res Ed). 2015;350:g7857.
   Google Scholar