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. 2022 Sep 30:13:993239.
doi: 10.3389/fphar.2022.993239. eCollection 2022.

Comparison of dexmedetomidine and remifentanil on reducing coughing during emergence from anesthesia with tracheal intubation: A meta-analysis

Xing Fan  1   2 , Hai Cai  1 , Bingbing Pan  2 , Yubo Xie  1
Affiliations

Comparison of dexmedetomidine and remifentanil on reducing coughing during emergence from anesthesia with tracheal intubation: A meta-analysis

Xing Fan et al. Front Pharmacol. .

Abstract

Background: Dexmedetomidine and remifentanil are well known to suppress airway reflex during emergence from anesthesia, but which one is more effective is unclear. We conducted a meta-analysis to compare the effect of dexmedetomidine and remifentanil on reducing the occurrence of coughing. Methods: We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (published between 1 January 1950, and 30 December 2021; no language restrictions) comparing dexmedetomidine infusion with remifentanil infusion. The primary endpoint was the incidence of moderate to severe coughing during the recovery period. The secondary endpoints were the time of recovery and extubation, and residual sedation. We assessed pooled data by using a random-effects model. Results: Eight studies with 502 participants were included. The meta-analysis showed no statistically difference between dexmedetomidine and remifentanil in the occurrence of moderate to severe coughing during emergence from anesthesia (OR 1.45,95%CI 0.62-3.38), the extubation time (MD 0.93 min, 95%CI -0.28-2.14), and the residual sedation (OR 2.52, 95%CI 0.92-6.91). Compared with dexmedetomidine, the average recovery time of remifentanil was shorter (MD 3.88 min, 95%CI 1.01-6.75). Conclusion: Dexmedetomidine and remifentanil infusion had no difference in the occurrence of moderate to severe coughing during emergence from anesthesia. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021239710.

Keywords: dexmedetomidine; emergence coughing; extubation; general anaesthesia; remifentanil.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study selection process.
FIGURE 2
FIGURE 2
Risk of bias of the included studies.
FIGURE 3
FIGURE 3
Meta-analyses of dexmedetomidine versus remifentanil, comparing incidence of moderate to serve cough.
FIGURE 4
FIGURE 4
Meta-analyses of dexmedetomidine versus remifentanil, comparing the awareness and extubation time.
FIGURE 5
FIGURE 5
Meta-analyses of dexmedetomidine versus remifentanil, comparing the residual sedation.
See this image and copyright information in PMC

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