title: Effects of intravenous dexmedetomidine on emergence agitation in children under sevoflurane anesthesia: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Emergence agitation (EA) is a common complication in children under sevoflurane anesthesia. The aim of this meta-analysis was to evaluate the effects of intravenous dexmedetomidine on EA in children under sevoflurane anesthesia.
  
  
  METHODS
  A comprehensive literature search was conducted to identify clinical trials that evaluated the effects of intravenous dexmedetomidine and placebo on EA in children under sevoflurane anesthesia. The search collected trials from MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Web of Science. Analysis was conducted using STATA version 12.0. Data from each trial were pooled using relative ratio (RR) for dichotomous data or weighted mean difference (WMD) for continuous data and corresponding 95% confidence interval (95% CI). Heterogeneity assessment, sensitivity analysis, and publication bias were performed.
  
  
  RESULTS
  Twelve trials, in which 459 patients received dexmedetomidine and 353 patients received placebo, were included in this analysis. We found that intravenous dexmedetomidine decreased the incidences of EA (RR = 0.346, 95% CI 0.263 to 0.453, P<0.001), and postoperative pain (RR = 0.405, 95% CI 0.253 to 0.649, P<0.001). Intravenous dexmedetomidine also prolonged extubation time (WMD = 0.617, 95% CI 0.276 to 958, P<0.001), and emergence time (WMD = 0.997, 95% CI 0.392 to 1.561, P = 0.001). Further evidences are required to evaluate the incidence of postoperative nausea and vomiting (PONV). Sensitivity analysis strengthened evidences for lower incidences of EA, pain, and prolonged extubation time, and emergence time. Funnel plots did not detect any significant publication bias.
  
  
  CONCLUSIONS
  Meta-analysis demonstrated that dexmedetomidine decreased the incidence of EA in children under sevoflurane anesthesia.
authors.affiliation: Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Chengliang
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Xinyao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Jianqin
authors.initials: J
authors.lastname: Yan
mesh_terms: D060666:Airway Extubation; D000771:Anesthesia, Intravenous / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011595:Psychomotor Agitation / Q000209:etiology*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine