Clinical Effect of Dexmedetomidine in Preventing Postoperative Delirium in Patients Undergoing Cardiac Surger: A Meta-analysis of Randomized Controlled Trials
Abstract
Objective To evaluate the clinical effects of dexmedetomidine on preventing postoperative delirium in patients undergoing cardiac surgery by Meta-analysis. Methods PubMed, Cochrane Library Embase, Web of Science database were searched for randomized controlled trials (RCTs) of dexmedetomidine in the prevention of postoperative delirium in patients undergoing cardiac surgery. The experimental group was treated with dexmedetomidine, and the control group was intervened with placebo or other anesthetic drugs. The search time is from inception to 31 December 2022. Two reviewers evaluated the quality of the literature independently, and Meta-analysis was performed using RevMan5.3 software. A total of 15 RCTs were enrolled, including 3222 subjects, In which 1625 cases in the experimental group and 1597 cases in the control group. Results Meta-analysis results showed that dexmedetomidine could reduce the incidence of postoperative delirium in patients with cardiac surgery [relative risk ratio (RR) = 0.65, 95 % confidence interval (CI) (0.48, 0.87), P = 0.0004], but it may increase the risk of postoperative hypotension [RR = 1.23, 95%CI(1.11, 1.36), P＜0.001] ,meanwhile the incidence of postoperative bradycardia [RR = 1.38, 95 % CI (0.7, 2.70), P = 0.04] and postoperative atrial fibrillation [RR = 0.92, 95 % CI (0.8, 1.07), P = 0.45] had no significant difference between two groups. Conclusion Dexmedetomidine has a certain effect on the prevention of postoperative delirium in patients undergoing cardiac surgery，it may increase the risk of postoperative hypotension, but not increase the incidence of postoperative bradycardia and postoperative atrial fibrillation. But this needs to be confirmed by more high-quality and large-sample studies.
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DOI: http://dx.doi.org/10.18686/jn.v12i1.245
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