title: [Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane: a meta-analysis].
abstract: OBJECTIVE
  Sevoflurane is often used in pediatric anesthesia and is associated with high incidence of psychomotor agitation. In such cases, dexmedetomidine (DEX) has been used, but its benefit and implications remain uncertain. We assessed the effects of DEX on agitation in children undergoing general anesthesia with sevoflurane.
  
  
  METHODS
  Meta-analysis of randomized clinical and double-blind studies, with children undergoing elective procedures under general anesthesia with sevoflurane, using DEX or placebo. We sought articles in English in PubMed database using the following terms: Dexmedetomidine, sevoflurane (Methyl Ethers/sevoflurante), and agitation (Psychomotor Agitation). Duplicate articles with children who received premedication and used active control were excluded. It was adopted random effects model with DerSimonian-Laird testing and odds ratio (OR) calculation for dichotomous variables, and standardized mean difference for continuous variables, with their respective 95% confidence interval (CI).
  
  
  RESULTS
  Of 146 studies identified, 10 were selected totaling 558 patients (282 in DEX group and 276 controls). The use of DEX was considered a protective factor for psychomotor agitation (OR=0.17; 95% CI 0.13 to 0.23; p<0.0001) and nausea and vomiting in PACU (OR=0.49; 95% CI 0.35 to 0.68; p<0.0001). Wake-up time and PACU discharge time were higher in the dexmedetomidine group. There was no difference between groups for extubation time and duration of anesthesia.
  
  
  CONCLUSIONS
  Dexmedetomidine reduces psychomotor agitation during wake-up time of children undergoing general anesthesia with sevoflurane.
authors.affiliation: Centro de Ensino e Treinamento José Quinan, Goiânia, GO, Brasil. Electronic address: marcomc18@hotmail.com.
authors.forename: Marco Aurélio Soares
authors.initials: MA
authors.lastname: Amorim
authors.affiliation: Universidade de Brasília (UnB), Centro de Ensino e Treinamento, Brasília, DF, Brasil; Sociedade Brasileira de Anestesiologia, Rio de Janeiro, RJ, Brasil; Universidade de Brasília (UnB), Faculdade de Ciências Médicas, Brasília, DF, Brasil.
authors.forename: Catia Sousa
authors.initials: CS
authors.lastname: Govêia
authors.affiliation: Sociedade Brasileira de Anestesiologia, Rio de Janeiro, RJ, Brasil; Universidade de Brasília (UnB), Brasília, DF, Brasil; Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
authors.forename: Edno
authors.initials: E
authors.lastname: Magalhães
authors.affiliation: Hospital Universitário de Brasília, Brasília, DF, Brasil.
authors.forename: Luís Cláudio Araújo
authors.initials: LC
authors.lastname: Ladeira
authors.affiliation: Secretaria de Saúde do Distrito Federal, Brasília, DF, Brasil.
authors.forename: Larissa Govêia
authors.initials: LG
authors.lastname: Moreira
authors.affiliation: Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brasil; Universidade Federal de Goiás (UFG), Instituto de Medicina Tropical e Saúde Pública, Goiânia, GO, Brasil.
authors.forename: Denismar Borges
authors.initials: DB
authors.lastname: de Miranda
mesh_terms: D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D002648:Child; D020927:Dexmedetomidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D000077149:Sevoflurane; D020927:Dexmedetomidine
keywords: Agitação psicomotora; Anestesia geral; Anestésicos inalatórios; Dexmedetomidina; Dexmedetomidine; General anesthesia; Inhalational anesthetics; Metanálise; Meta‐analysis; Psychomotor agitation