title: Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: A meta-analysis with trial sequential analysis of randomized controlled trials.
abstract: It is uncertain whether dexmedetomidine is better than propofol for sedation in postcardiac surgery patients. The purpose of this meta-analysis was to compare the effects of dexmedetomidine and propofol sedation on outcomes in adult patients after cardiac surgery.
  
  
  
  Randomized controlled trials comparing outcomes in cardiac surgery patients sedated with dexmedetomidine or propofol were retrieved from PubMed, Embase, Web of Science, the Cochrane Library, and Clinicaltrials.Gov until May 23, 2016.
  
  
  
  A total of 969 patients in 8 studies met the selection criteria. The results revealed that dexmedetomidine was associated with a lower risk of delirium (risk ratio, 0.40;95% confidence interval [CI], 0.24-0.64; P=.0002), a shorter length of intubation (hours; mean difference, -0.95; 95% CI, -1.26 to -0.64; P<.00001), but a higher incidence of bradycardia (risk ratio 3.17; 95% CI, 1.41-7.10; P=.005) as compared to propofol. There were no statistical differences in the incidence of hypotension or atrial fibrillation, or the length of intensive care unit stay between dexmedetomidine and propofol sedation regimens.
  
  
  
  Dexmedetomidine sedation could reduce postoperative delirium and was associated with shorter length of intubation, but might increase bradycardia in patients after cardiac surgery compared with propofol.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Guohao
authors.initials: G
authors.lastname: Xie
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Shengwen
authors.initials: S
authors.lastname: Song
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Song
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Electronic address: xiangming_fang@163.com.
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
mesh_terms: D001026:Coronary Artery Bypass; D003693:Delirium / Q000188:drug therapy*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007362:Intensive Care Units; D011183:Postoperative Complications / Q000188:drug therapy; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D015742:Propofol