Safety and efficacy of dexmedetomidine for flexible bronchoscopy: A systematic review and meta-analysis
Abstract
BACKGROUND
Dexmedetomidine (DEX) is a drug that is specifically an agonist for the alpha-2 adrenergic receptor, which has been explored for potential use in the provision of anesthesia during flexible bronchoscopy. Tactical mechanisms enable DEX to be able to provide sedation without marked respiratory depression hence aiding patients with poor respiratory reserve.
AIM
To investigate the safety and efficacy of DEX by examining heart rate, blood pressure, oxygen saturation, patient satisfaction and adverse effects.
METHODS
A meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted across PubMed, Scopus, and the Cochrane Library. Randomized controlled trials comparing DEX with other sedatives (midazolam, remimazolam, propofol) during bronchoscopy were included. Primary outcomes were mean heart rate, mean oxygen saturation, and patient discomfort. Secondary outcomes included Ramsay Sedation Score, cough, pain and distress, ease of bronchoscopy, quality of sedation, composite scores, and adverse effects. A random-effects model was used for analysis.
RESULTS
Fourteen randomized controlled trials involving 1920 patients were finalized. Patients using DEX had a higher mean oxygen saturation throughout the procedure (P < 0.0003, I ² = 18%) and a decreased mean heart rate (P < 0.00001, I ² = 22%). Additionally, DEX significantly increased the incidence of bradycardia (P = 0.00001, I ² = 53%). The results show no difference in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,920 participants or records.
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