Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

被引:20
作者
Feng, Ji-Feng [1 ]
Wang, Xiao-Xia [1 ]
Lu, Yan-Yan [1 ]
Pang, Deng-ge [1 ]
Peng, Wei [1 ]
Mo, Jian-lan [1 ]
机构
[1] Hosp Guangxi Zhuang Autonomous Reg, Dept Anesthesiol Obstet & Gynecol, Xiang Zhu Rd 59, Nanning 530003, Guangxi, Peoples R China
关键词
Dexmedetomidine; midazolam; paediatric anaesthesia; sevoflurane; meta-analysis; INTRANASAL DEXMEDETOMIDINE; EMERGENCE AGITATION; ORAL MIDAZOLAM; PREANESTHETIC MEDICATION; AMBULATORY SURGERY; CAUDAL ANESTHESIA; DOUBLE-BLIND; CHILDREN; INDUCTION; CLONIDINE;
D O I
10.1177/0300060517704595
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background Dexmedetomidine (DEX), an (2)-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane. Methods PubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia. The risk ratio (RR) with 95% incidence interval (95%CI) was used for dichotomous variables. Results Twelve RCTs involving 422 patients in the DEX group and 448 patients in the MDZ group were included. Patients in the DEX group had a significantly lower incidence of unsatisfactory sedation (RR [95%CI]=0.71 [0.57-0.89]), unsatisfactory parental separation (RR [95%CI]=0.56 [0.35-0.87]), and rescue analgesia (RR [95%CI]=0.52 [0.35-0.77]) than patients in the MDZ group. However, both groups had a similar incidence of unsatisfactory mask acceptance, emergence agitation, and postoperative nausea and vomiting. Conclusion Compared with MDZ, DEX is beneficial in paediatric anaesthesia with sevoflurane because of its lower incidence of unsatisfactory sedation, parental separation, and rescue analgesia.
引用
收藏
页码:912 / 923
页数:12
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