Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (1): 1-10.doi: 10.24920/004088
• Original Article • Next Articles
Li-Juan Tian1, *(), Yun-Tai Yao1, Su Yuan1, Zheng Dai2
Received:
2022-03-21
Accepted:
2022-07-27
Published:
2023-03-31
Online:
2022-09-19
Contact:
Li-Juan Tian
E-mail:tlijuan1982@163.com
Li-Juan Tian, Yun-Tai Yao, Su Yuan, Zheng Dai. Effect of Dexmedetomidine on Maintaining Perioperative Hemodynamic Stability in Elderly Patients: A Systematic Review and Meta-analysis[J].Chinese Medical Sciences Journal, 2023, 38(1): 1-10.
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Table 1.
Baseline characteristics of included studies for meta-analysis"
Author, year | Sample size | Dexmedetomidine dose/administration | Control group | Surgery | |
---|---|---|---|---|---|
Dex | Con | ||||
Qiao, 2020[ | 50 | 50 | 0.40 μg/kg loading | Blank | Undergoing laparoscopic cholecystectomy |
Li, 2015[ | 20 | 20 | 1.00 μg/kg loading | Blank | ERCP |
Song, 2017[ | 30 | 30 | 1.00 μg/kg loading | Blank | Undergoing tracheal intubation under general anesthesia |
Chen, 2019[ | 90 | 30 | 0.20, 0.40, 0.60 μg/kg/h infusion | Saline | Colorectal cancer surgery |
Lin, 2017[ | 44 | 22 | 0.50, 1.00 μg/kg loading; 0.50 μg/kg/h infusion | Blank | Radical resection of esophageal carcinoma under thoracoscopy surgery |
Su, 2014[ | 25 | 25 | 0.50 μg/kg loading; 0.40 μg/kg/h infusion | Saline | Thoracolumbar surgery |
Zhang, 2018[ | 30 | 30 | 0.50 μg/kg loading | Saline | Abdominal operation |
Cao, 2018[ | 90 | 0 | 0.30, 0.50, 0.70 μg/kg loading | Blank | Radical resection of colorectal cancer |
Guan, 2015[ | 60 | 20 | 0.25, 0.50, 1.00 μg/kg loading; constant speed infusion in 10mins | Saline | Abdominal surgery |
Lee, 2017[ | 20 | 20 | 0.50 μg/kg loading; constant speed infusion in 10 min | Saline | Hypertension patients with noncardiac surgery |
Ko, 2015[ | 47 | 0 | 0.10, 0.30, 0.50, 0.70, 1.00 μg/kg loading | Blank | Orthopedic or urologic surgery |
Du, 2019[ | 40 | 40 | 0.60 μg/kg/h infusion | Saline | Laparoscopic cholecystectomy surgery |
Table 2.
Summary of included studies"
Indexes | No. of studies | Sample size | SMD (95% CI) | Heterogeneity | |
---|---|---|---|---|---|
I2 (%) | P value | ||||
Comparison between before and after operation | |||||
MAP | 8 | 450 | 0.12 (-0.54, 0.79) | 93.1 | <0.001 |
HR | 10 | 550 | 0.13 (-0.44, 0.70) | 91.7 | <0.001 |
SBP | 4 | 200 | 1.38 (0.11, 2.64) | 93.5 | <0.001 |
DBP | 4 | 200 | 1.11 (-0.25, 2.46) | 94.5 | <0.001 |
Comparison between dexmedetomidine and control | |||||
MAP | 8 | 440 | -1.12 (-1.60, -0.63) | 81.6 | <0.001 |
HR | 10 | 540 | -0.87 (-1.13, -0.62) | 50.8 | 0.032 |
SBP | 4 | 200 | -1.27 (-2.26, -0.27) | 90.0 | <0.001 |
DBP | 4 | 200 | -0.96 (-1.33, -0.59) | 34.9 | 0.203 |
Time effect of SBP and HR with 0.5 μg/kg and 1.0 μg/kg dexmedetomidine, respectively | |||||
SBP(0.5, 0) | 3 | 112 | -1.17 (-3.36, 1.02) | 96.0 | <0.001 |
SBP(0.5, 10) | 3 | 112 | -0.07 (-0.43, 0.28) | 0.0 | 0.686 |
SBP(0.5, 20) | 2 | 62 | -0.59 (-1.10, -0.08) | 0.0 | 0.320 |
SBP(1, 0) | 2 | 64 | -0.24 (-0.73, 0.25) | 0.0 | 0.889 |
SBP(1, 10) | 2 | 64 | -0.86 (-1.95, 0.22) | 74.5 | 0.048 |
SBP(1, 20) | 2 | 64 | -0.24 (-0.73, 0.25) | 0.0 | 0.889 |
HR(0.5, 0) | 5 | 212 | -0.41 (-0.95, 0.13) | 72.4 | 0.006 |
HR(0.5, 10) | 5 | 212 | -0.73 (-1.51, 0.04) | 85.7 | <0.001 |
HR(0.5, 20) | 3 | 102 | -1.48 (-2.30, -0.66) | 68.5 | 0.042 |
HR(1, 0) | 2 | 64 | -0.14 (-0.63, 0.35) | 0.0 | 0.340 |
HR(1, 10) | 2 | 64 | -1.53 (-2.09, -0.97) | 0.0 | 0.709 |
HR(1, 20) | 2 | 64 | -1.96 (-2.56, -1.36) | 0.0 | 0.944 |
Table 3.
Evaluation of publication bias and sensitivity analysis"
Index | Egger's regression | Duval and Tweedie's trim and fill | ||||
---|---|---|---|---|---|---|
Intercept | P value | Original OR | Studies trimmed | Adjusted OR | ||
Comparison between before and after operation | ||||||
MAP | 9.392 | 0.334 | 0.12 (-0.54, 0.79) | 2 | -0.18 (-0.84, 0.49) | |
HR | 18.491 | 0.067 | 0.13 (-0.44, 0.71) | 3 | -0.21 (-0.78, 0.36) | |
Comparison between dexmedetomidine and control (blank or saline) | ||||||
MAP | -2.395 | 0.669 | -1.12 (-1.61, -0.63) | 0 | -1.12 (-1.61, -0.63) | |
HR | 2.967 | 0.408 | -0.87 (-1.13, -0.62) | 0 | -0.87 (-1.13, -0.62) |
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