Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials
- PMID: 26550123
- PMCID: PMC4612808
Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials
Retraction in
- Int J Clin Exp Med. 2016;9(10):20465
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Efficacy of dexmedetomidine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials [Retraction].Int J Clin Exp Med. 2016 Oct 15;9(10):20465. eCollection 2016. Int J Clin Exp Med. 2016. PMID: 29874327 Free PMC article.
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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References
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- Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 1992;77:162–184. - PubMed
-
- Watcha MF, White PF. New antiemetic drugs. Int Anesthesiol Clin. 1995;33:1–20. - PubMed
-
- Gan TJ. Postoperative nausea and vomiting--can it be eliminated? JAMA. 2002;287:1233–1236. - PubMed
-
- Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91:693–700. - PubMed
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