The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

• Published in: PloS one Vol. 13; no. 9; p. e0202620
• Main Authors: Wang, Guobin, Niu, Jianhua, Li, Zhitao, Lv, Haifeng, Cai, Hongliu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19-09-2018; Public Library of Science (PLoS)
• Subjects: Analgesics, Non-Narcotic - adverse effects; Analgesics, Non-Narcotic - therapeutic use; Anesthesia; Blood pressure; Bradycardia; Cardiac patients; Cardiac Surgical Procedures - methods; Clinical trials; Confidence intervals; Congenital diseases; Data processing; Dexmedetomidine; Dexmedetomidine - adverse effects; Dexmedetomidine - therapeutic use; Dosage and administration; Effectiveness; Fibrillation; Health aspects; Heart rate; Heart surgery; Hemodynamics; Hospitals; Humans; Hypotension; Intensive Care Units; Medical research; Medicine and Health Sciences; Mental disorders; Meta-analysis; Operative Time; Patients; Physical Sciences; Postoperative Complications - epidemiology; Randomized Controlled Trials as Topic; Research and Analysis Methods; Safety; Safety and security measures; Studies; Surgery; Systematic review; Tachycardia; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0202620

This study aimed to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients who have undergone cardiac surgery. Electronic databases including PubMed, Embase, and Cochrane Library were systematically searched without limitations of language and publication time. Randomized controlled trials (RCTs) aiming to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients that have undergone cardiac surgery were selected. Endpoints such as hemodynamic indexes and adverse events in eligible studies were extracted by two researchers, independently. The data was analyzed using RevMan 5.3 and Stata 11.0 software. A total of 18 RCTs met the inclusion criteria, involving 1730 patients. Compared to control (any treatment without dexmedetomidine), dexmedetomidine showed a pooled mean difference (MD) of -14.46 [95% confidence interval(CI): -24.69, -4.23; p<0.01] for systolic arterial pressure, a standardized mean difference (SMD) of -1.74 for mean arterial blood pressure (95% CI: -2.80, -0.68; P < 0.01), -2.12 (95%CI: -3.23, -1.00; p<0.01) for heart rate, and combined odds ratio (OR) of 0.22 (95%CI: 0.11, 0.44; p<0.01) for tachycardia, 3.44 (95%CI: 1.95, 5.96; p<0.01) for bradycardia, 0.74 (95%CI: 0.49, 1.12; p>0.05) for atrial fibrillation, and 0.99 (95%CI: 0.51, 1.90; p>0.05) for hypotension. In addition, dexmedetomidine could reduce time of surgery and stay in intensive care units, improve delirium with good safety. Our study shows clinical application of dexmedetomidine in cardiac surgery patients can reduce risks of abnormal hemodynamics with good safety.