Josephine, C. and Shariffuddin, Ina Ismiarti and Hui, Chaw Sook and Ng, Kevin Wei Shan and Ng, Ka Ting (2021) Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Asian journal of anesthesiology, 59 (1). pp. 7-21. ISSN 2468824X, DOI https://doi.org/10.6859/aja.202103_59(1).0002.
Full text not available from this repository.Abstract
Dexmedetomidine is a highly selective α2-adrenoceptor agonist, which is off-labelled use for pediatric sedation. However, the hemodynamic responses of dexmedetomidine remain unclear in the pediatric population. The primary objectives of this systematic review and meta-analysis were to examine the hemodynamic effects of high-dose and low-dose dexmedetomidine in pediatric patients undergoing surgery. EMBASE, MEDLINE, and CENTRAL were systematically searched from its inception until April 2019. All randomized clinical trials comparing high-dose (＞ 0.5 mcg/kg) and low-dose (≤ 0.5 mcg/ kg) dexmedetomidine in pediatric surgical patients were included, regardless of the types of surgeries. Observational studies, case series, and case reports were excluded. Four trials (n = 473) were included in this review. Our review demonstrated that high-dose dexmedetomidine was associated with lower heart rate than low-dose dexmedetomidine after intravenous bolus of dexmedetomidine (studies, 3; n = 274; mean difference MD, -5 -6 to -4; P ＜ 0.0001) and during surgical stimulant (studies, 2; n = 153; MD, -11 -13 to -9; P ＜ 0.0001). In comparison to the low-dose dexmedetomidine, high-dose dexmedetomidine was also associated with a significant longer recovery time (studies, 3; n = 257; MD, 5.90 1.56 to 10.23; P = 0.008) but a lower incidence of emergence agitation (studies, 2; n = 153; odds ratio, 0.17 0.03 to 0.95; P = 0.040). In this meta-analysis, low-dose dexmedetomidine demonstrated better hemodynamic stability with shorter recovery time than high-dose dexmedetomidine. However, these findings need to be interpreted with caution due to limited published studies, a small sample size, and a high degree of heterogeneity.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Anesthesia, General; Child; Dexmedetomidine; Emergence Delirium; Hemodynamics; Humans; Randomized Controlled Trials as Topic |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RJ Pediatrics R Medicine > RJ Pediatrics > Child health. Child health services |
| Divisions: | Faculty of Medicine Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 27 Nov 2023 05:27 |
| Last Modified: | 29 Nov 2023 03:46 |
| URI: | http://eprints.um.edu.my/id/eprint/35674 |
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