title: Effect of dexmedetomidine on preventing postoperative agitation in children: a meta-analysis.
abstract: BACKGROUND
  Emergence agitation (EA) is one of the most common postoperative complications in children. The purpose of this meta-analysis is to assess the effect of dexmedetomidine for preventing postoperative agitation in children.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trails, MEDLINE, and EMBASE. Randomized controlled trials were included. The following outcome measures were evaluated: incidence of EA, number of patients requiring rescue, time to eye-open, time to extubation, time to discharge from the postanesthesia care unit (PACU).
  
  
  RESULTS
  We analyzed 19 trials (1608 patients) that met the inclusion criteria. Compared with placebo, intravenous dexmedetomidine significantly reduced the incidence of EA [risk ratio (RR) 0.34, 95% confidence interval (CI) 0.25-0.44, P<0.00001). Dexmedetomidine also decreased the incidence of severe pain (RR 0.41, 95% CI 0.27-0.62, P<0.0001) and requirement of a rescue drug (RR 0.31, 95% CI 0.18-0.53, P<0.0001). However, compared with placebo, dexmedetomidine increased the time to eye-open by 0.98 min (P = 0.01) and the time to PACU discharge by 4.63 min (P = 0.02). Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others. No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.
  
  
  CONCLUSIONS
  Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs. It slightly increased the time to eye-open and the time to PACU discharge. Dexmedetomidine was also more beneficial than propofol or fentanyl in preventing EA.
authors.affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Ni
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jiafu
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Linli
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Anaesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Luo
mesh_terms: D000762:Anesthesia Recovery Period; D002648:Child; D020927:Dexmedetomidine / Q000627:therapeutic use*; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy*; D011595:Psychomotor Agitation / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D020927:Dexmedetomidine