was significantly associated with a decreased incidence of (POD) among 4173 elderly patients.
The relative risk (RR) of developing POD with dexmedetomidine was 0.58, indicating a notable reduction.
In noncardiac surgery patients, the incidence of POD was reduced with an RR of 0.51 when dexmedetomidine was used.
Applying dexmedetomidine during the postoperative period resulted in an RR of 0.53 for reduced POD incidence.
Both low-doses (RR 0.54) and normal-doses (RR 0.59) of dexmedetomidine were associated with decreased POD incidence.
There were no significant changes in POD incidence for cardiac surgery patients (RR = 0.71) or when administered during the intra- or perioperative period.
Simplified
BACKGROUND: Delirium is a common postoperative complication. Many studies have found that is associated with a reduced incidence of (POD). This meta-analysis aimed to analyze the effects of dexmedetomidine on POD incidence among elderly patients undergoing general anesthesia.
METHODS: We searched 4 electronic databases (i.e., Pubmed, Embase, Cochrane, and Web of Science) from inception to November 30, 2020, for randomized controlled trials that evaluated the effects of dexmedetomidine in preventing the occurrence of POD in elderly patients (aged ≥60 years). The study protocol was registered in PROSPERO (CRD42020192114).
RESULTS: 14 studies with 4173 patients showed that dexmedetomidine was significantly associated with a decreased POD incidence among elderly patients (relative risk [RR] = 0.58; 95% confidence interval [CI] = 0.44-0.76). The incidence of POD was significantly reduced in the noncardiac surgery group (RR 0.51; 95% CI 0.37-0.72), when dexmedetomidine was applied during the postoperative period (RR = 0.53; 95% CI = 0.40-0.70), and in patients received low-doses (RR = 0.54; 95% CI = 0.34-0.87) and normal-doses (RR = 0.59; 95% CI = 0.42-0.83). There were no significant differences in POD incidence in the cardiac surgery group (RR = 0.71; 95% CI = 0.45-1.11), and when dexmedetomidine was applied during the intra- (RR = 0.55; 95% CI = 0.29-1.01) or perioperative period (RR = 0.95; 95% CI = 0.64-1.40).
CONCLUSIONS: Our meta-analysis suggests that dexmedetomidine may significantly reduce POD incidence in elderly noncardiac surgery patients and when applied during the postoperative period, in addition, both low- and normal-doses of dexmedetomidine may reduce POD incidence. However, its use in cardiac surgery patients and during the intra- or perioperative period may have no significant effects on POD incidence.
Key numbers
0.58
Decrease in Incidence
Relative risk of incidence with
0.51
Noncardiac Surgery Reduction
Relative risk for noncardiac surgery patients
0.53
Postoperative Administration Effect
Relative risk for postoperative administration
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