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. 2015 Aug 15;8(8):12113-34.
eCollection 2015.

Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials

Xiao Liang  1 , Miao Zhou  2 , Jiao-Jiao Feng  3 , Liang Wu  2 , Shang-Ping Fang  4 , Xin-Yu Ge  5 , Hai-Jing Sun  4 , Peng-Cheng Ren  6 , Xin Lv  7
Affiliations

Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials

Xiao Liang et al. Int J Clin Exp Med. .

Retraction in

Abstract

Purpose: Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on PONV.

Methods: Two researchers independently searched PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs). The meta-analysis was performed with Review Manager.

Results: Eighty-two trials with 6,480 patients were included in this meta-analysis. Dexmedetomidine reduced postoperative nausea (Risk Ratio (RR) = 0.61, 95% confidence interval (CI): 0.50 to 0.73) and vomiting (RR = 0.48, 95% CI: 0.36 to 0.64) compared with placebo, with an effective dose of 0.5 ug/kg (RR = 0.46, 95% CI: 0.34 to 0.62) and 1.0 ug/kg (RR = 0.29, 95% CI: 0.12 to 0.75), respectively. The antiemetic effect can only be achieved intravenously, not epidurally or intrathecally. The efficacy of dexmedetomidine was similar to that of widely used agents, such as propofol, midazolam etc., but better than opioid analgesics. Moreover, application of dexmedetomidine reduced intraoperative requirement of fentanyl (Standard Mean Difference = -1.91, 95% CI: -3.20 to -0.62).

Conclusions: The present meta-analysis indicates that dexmedetomidine shows superiority to placebo, but not to all other anesthetic agents on PONV. And this efficacy may be related to a reduced consumption of intraoperative opioids.

Keywords: Dexmedetomidine; meta-analysis; nausea; vomiting.

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Figures

Figure 1
Figure 1
Flow diagram of the inclusion and exclusion process.
Figure 2
Figure 2
Summary of the risk of bias of the included studies.
Figure 3
Figure 3
Results of subgroup analysis of the incidence of postoperative nausea by anesthesia types.
Figure 4
Figure 4
Results of subgroup analysis of the incidence of postoperative vomiting by anesthesia types.
Figure 5
Figure 5
Results of subgroup analysis of the incidence of postoperative nausea by routes of dexmedetomidine administration.
Figure 6
Figure 6
Results of subgroup analysis of the incidence of postoperative vomiting by routes of dexmedetomidine administration.
Figure 7
Figure 7
Consumption of intraoperative fentanyl with the application of dexmedetomidine.
See this image and copyright information in PMC

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