Efficacy of dexmedetomidine in preventing emergence agitation in children undergoing tonsillectomy and/or adenoidectomy: a meta-analysis and systematic review
Abstract
INTRODUCTION: Emergence agitation (EA) affects 10–80% of children after general anesthesia, with high rates following tonsillectomy and/or adenoidectomy. Although dexmedetomidine shows potential for preventing EA, its efficacy and safety in this specific pediatric population remain uncertain, with conflicting evidence from previous studies. METHODS: Computerized searches of PubMed, The Cochrane Library, Web of Science, Embase, and OpenGrey were performed, and the search timeframe was from the time of construction to September 26, 2024, for all searches. Literature screening, data extraction, and evaluation of the risk of bias of the included studies were performed independently by two investigators. A meta-analysis was performed using STAT14 software, and heterogeneity was examined through subgroup analysis and meta-regression for route of administration, control medications, general anesthesia procedures, and EA assessment methods. The certainty of results was checked using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. RESULTS: Our study comprised 19 studies with 1697 children. Dexmedetomidine significantly reduced the incidence of EA in thirteen studies of 1222 children (RR = 0.36, 95% CI [0.30, 0.45], P = 0.036, I2 = 45.7%, GRADE = high). Subgroup analyses and meta-regression showed that different scales were the source of heterogeneity in EA incidence outcomes and that dexmedetomidine was more potent than other medications in…
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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: 1,697 participants or records.
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