Cover Image

Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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 he...

Full description

Saved in:
Bibliographic Details
Main Authors: Josephine, C., Shariffuddin, Ina Ismiarti, Hui, Chaw Sook, Ng, Kevin Wei Shan, Ng, Ka Ting
Format: Article
Published: Taiwan Society of Anesthesiologists 2021
Subjects:
R Medicine (General)
RJ Pediatrics
Child health. Child health services
Online Access:http://eprints.um.edu.my/35674/
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85112124449&doi=10.6859%2faja.202103_59%281%29.0002&partnerID=40&md5=bdae825969bb8051ef6f629f023219c9
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.um.eprints.35674
record_format eprints
spelling my.um.eprints.356742023-11-29T03:46:56Z http://eprints.um.edu.my/35674/ Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Josephine, C. Shariffuddin, Ina Ismiarti Hui, Chaw Sook Ng, Kevin Wei Shan Ng, Ka Ting R Medicine (General) RJ Pediatrics Child health. Child health services 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. Taiwan Society of Anesthesiologists 2021 Article PeerReviewed 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 <https://doi.org/10.6859/aja.202103_59(1).0002>. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85112124449&doi=10.6859%2faja.202103_59%281%29.0002&partnerID=40&md5=bdae825969bb8051ef6f629f023219c9 10.6859/aja.202103_59(1).0002
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
RJ Pediatrics
Child health. Child health services
spellingShingle R Medicine (General)
RJ Pediatrics
Child health. Child health services
Josephine, C.
Shariffuddin, Ina Ismiarti
Hui, Chaw Sook
Ng, Kevin Wei Shan
Ng, Ka Ting
Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
description 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.
format Article
author Josephine, C.
Shariffuddin, Ina Ismiarti
Hui, Chaw Sook
Ng, Kevin Wei Shan
Ng, Ka Ting
author_facet Josephine, C.
Shariffuddin, Ina Ismiarti
Hui, Chaw Sook
Ng, Kevin Wei Shan
Ng, Ka Ting
author_sort Josephine, C.
title Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Hemodynamic Response of High- and Low-Dose Dexmedetomidine of Pediatric in General Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort hemodynamic response of high- and low-dose dexmedetomidine of pediatric in general anesthesia: a systematic review and meta-analysis of randomized controlled trials
publisher Taiwan Society of Anesthesiologists
publishDate 2021
url http://eprints.um.edu.my/35674/
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85112124449&doi=10.6859%2faja.202103_59%281%29.0002&partnerID=40&md5=bdae825969bb8051ef6f629f023219c9
_version_ 1783876626869649408
score 13.211869

Similar Items