The Influence of Perioperative Dexmedetomidine on Patients Undergoing Cardiac Surgery: A Meta-Analysis

The use of dexmedetomidine may have benefits on the clinical outcomes of cardiac surgery. We conducted a meta-analysis comparing the postoperative complications in patients undergoing cardiac surgery with dexmedetomidine versus other perioperative medications to determine the influence of perioperat...

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Bibliographic Details
Published in:PloS one 2016-04, Vol.11 (4), p.e0152829-e0152829
Main Authors: Geng, Jun, Qian, Ju, Cheng, Hao, Ji, Fuhai, Liu, Hong
Format: Article
Language:English
Subjects:
Analysis
Anesthesia
Anesthesiology
Atrial fibrillation
Bias
Bradycardia
Cardiac arrhythmia
Care and treatment
Citation analysis
Clinical trials
Complications
Confidence intervals
Control methods
Coronary vessels
Delirium
Dexmedetomidine
Dexmedetomidine - therapeutic use
Dosage and administration
Drugs
Fibrillation
Health care costs
Heart
Heart diseases
Heart surgery
Hospitals
Humans
Hypotension
Intensive care
Management
Medicine and Health Sciences
Mental disorders
Meta-analysis
Mortality
Patients
Perioperative Care
Physical Sciences
Randomization
Research and Analysis Methods
Research methods
Risk
Studies
Surgery
Tachycardia
Thoracic surgery
Thoracic Surgical Procedures
Veins & arteries
Ventricle
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Summary:The use of dexmedetomidine may have benefits on the clinical outcomes of cardiac surgery. We conducted a meta-analysis comparing the postoperative complications in patients undergoing cardiac surgery with dexmedetomidine versus other perioperative medications to determine the influence of perioperative dexmedetomidine on cardiac surgery patients. Randomized or quasi-randomized controlled trials comparing outcomes in patients who underwent cardiac surgery with dexmedetomidine, another medication, or a placebo were retrieved from EMBASE, PubMed, the Cochrane Library, and Science Citation Index. A total of 1702 patients in 14 studies met the selection criteria among 1,535 studies that fit the research strategy. Compared to other medications, dexmedetomidine has combined risk ratios of 0.28 (95% confidence interval [CI] 0.15, 0.55, P = 0.0002) for ventricular tachycardia, 0.35 (95% CI 0.20, 0.62, P = 0.0004) for postoperative delirium, 0.76 (95% CI 0.55, 1.06, P = 0.11) for atrial fibrillation, 1.08 (95% CI 0.74, 1.57, P = 0.69) for hypotension, and 2.23 (95% CI 1.36, 3.67, P = 0.001) for bradycardia. In addition, dexmedetomidine may reduce the length of intensive care unit (ICU) and hospital stay. This meta-analysis revealed that the perioperative use of dexmedetomidine in patients undergoing cardiac surgery can reduce the risk of postoperative ventricular tachycardia and delirium, but may increase the risk of bradycardia. The estimates showed a decreased risk of atrial fibrillation, shorter length of ICU stay and hospitalization, and increased risk of hypotension with dexmedetomidine.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0152829