title: Dexmedetomidine for antiemesis in gynecologic surgery: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Postoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries.
  
  
  METHODS
  Three main electronic databases including Pub Med, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) were searched by two researchers independently. The metaanalysis was completed using Review Manager.
  
  
  RESULTS
  Eleven RCTs with 692 patients were included in this metaanalysis. Dexmedetomidine a bridged postoperative nausea [Risk Ratio (RR)=0.59, 95% confidence interval (CI): 0.44 to 0.79] and vomiting [RR=0.48, 95% CI: 0.36 to 0.64] compared with placebo. Despite of higher incidence of intra operative bradycardia [RR 2.87, 95% CI 1.08 to 7.58] and hypotension [RR 4.26, 95% CI 1.43 to 12.69], we found significant decrease in postoperative shivering [RR 0.23, 95% CI 0.13 to 0.40] and pruritus [RR 0.40, 95% CI 0.17 to 0.93] in dexmedetomidine group, as well as the pain scores [standard mean difference (SMD)-0.96, 95% CI-1.37 to-0.54]. Significant reductions in the need for intraoperative fentanyl (RR 0.10, 95% CI 0.01-0.76, I(2) 0%), antiemetic (RR 0.62, 95% CI 0.39-0.99, I(2) 0%) and postoperative analgesic (RR 0.18, 95% CI 0.08-0.42, I(2) 0%) were also elicited.
  
  
  CONCLUSIONS
  The current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.
authors.affiliation: Department of Obstetrics, Shanghai Changning District Maternity and Infant Health Hospital Changning District, Shanghai 200051, P. R. China.
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Zhong
authors.affiliation: Hebei North University, School of Medicine P. R. China ; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University Huangpu District, Shanghai 200003, P. R. China.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Ge
authors.affiliation: Department of Anesthesiology, Shanghai Putuo District Maternity and Children Healthcare Hospital P. R. China.
authors.forename: Hai
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University P. R. China ; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University Huangpu District, Shanghai 200003, P. R. China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Obstetrics and Gynecology, Shanghai Putuo District Maternity and Children Healthcare Hospital P. R. China.
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Gong
authors.affiliation: Department of Critical Care Medicine, Zhongshan Hospital, Fudan University P. R. China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhong
authors.affiliation: Section of Scientific Research Management, Changzheng Hospital, Second Military Medical University P. R. China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Xiao
keywords: Dexmedetomidine; PONV; gynecological surgery; meta-analysis