Chinese Medical Sciences Journal ›› 2024, Vol. 39 ›› Issue (1): 54-68.doi: 10.24920/004294
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Mei Wang1, Jian-Xiang Che1, Lei Chen1, Ting-Ting Song1, Jin-Tao Qu2, *()
Received:
2023-08-23
Accepted:
2024-01-22
Published:
2024-03-31
Online:
2024-03-01
Contact:
* Jin-Tao Qu, E-mail: Mei Wang, Jian-Xiang Che, Lei Chen, Ting-Ting Song, Jin-Tao Qu. Effect of Dexmedetomidine on Intraoperative Hemodynamics and Blood Loss in Patients Undergoing Spine Surgery: A Systematic Review and Meta-Analysis[J].Chinese Medical Sciences Journal, 2024, 39(1): 54-68.
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Table 1.
Characteristics of the included trials."
Author year | Country | Age range (ys) | Sample size (n) | Intervention | Outcome measures | Surgery type | |
---|---|---|---|---|---|---|---|
Dex | Saline | ||||||
Li 2016 | China | 18 — 65 | 30 | 30 | Loading dose of 0.5μg·kg-1 for 10min; maintenance dose of 0.2μg·kg-1·h-1 | ①② | Major spine surgery |
Li 2021* | China | 65 — 90 | D1: 30 D2: 30 D3: 30 | 30 | D1: Loading dose of 0.3μg·kg-1 for 10min; maintenance dose of 0.2μg·kg-1·h-1 D2: Loading dose of 0.3μg·kg-1 for 10min; maintenance dose of 0.5μg·kg-1·h-1 D3: Loading dose of 0.3μg·kg-1 for 10min; maintenance dose of 0.8μg·kg-1·h-1 | ①② | Spine surgery |
Sen 2013 | India | 20 — 60 | 35 | 35 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.2μg·kg-1·h-1 | ①② | Spine surgery |
Naik 2016 | USA | 18 — 80 | 63 | 68 | Loading dose of 1μg·kg-1 for 20min; maintenance dose of 0.5μg·kg-1·h-1 | ② | Thoracic and lumbar spine surgery |
Kim 2019 | Korea | 20 — 70 | 26 | 26 | Maintenance dose of 0.4μg·kg-1·h-1 | ③ | Spine fusion surgery |
Gandhi 2017 | India | 18 — 60 | 30 | 30 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.5μg·kg-1·h-1 | ①② | Cervical spine surgery |
Kwon 2018 | Korea | 20 — 65 | 35 | 35 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.3-0.5μg·kg-1·h-1 | ①② | Lumbar microdiscectomy |
Chen 2017 | China | 18 — 60 | 20 | 20 | Loading dose of 0.5μg·kg-1 for 10min; maintenance dose of 0.2μg·kg-1·h-1 | ③ | Posterior thoracolumbar surgery |
Ozkose 2006 | Turkey | ≥18 | 20 | 20 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.2μg·kg-1·h-1 | ② | Lumbar spine surgery |
Chen 2015* | China | 65 — 80 | D1: 14 D2: 15 | 14 | D1: Loading dose of 0.3μg·kg-1 for 10min; maintenance dose of 0.3μg·kg-1·h-1 D2: Loading dose of 0.8μg·kg-1 for 10min; maintenance dose of 0.8μg·kg-1·h-1 | ③ | Spine surgery |
Banik 2020 | India | 18 — 60 | 15 | 15 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.5μg·kg-1·h-1 | ③ | Lumbar spine surgery |
Kundra 2019 | India | 18 — 65 | 30 | 30 | Maintenance dose of 0.3μg·kg-1·h-1 | ①②③ | Lumbar spine surgery |
Rozet 2015 | USA | ≥18 | 20 | 20 | Loading dose of 0.6μg·kg-1 for 10min; maintenance dose of 0.6μg·kg-1·h-1 | ①② | Spine surgery |
Janatmakan 2019 | Iran | 20 — 50 | 38 | 39 | Loading dose of 0.5μg·kg-1 for 10min; maintenance dose of 0.25μg·kg-1·h-1 | ③ | Spine surgery |
Srivastava 2016 | India | 20 — 60 | 30 | 30 | Loading dose of 1μg·kg-1 for 15min; maintenance dose of 0.5μg·kg-1·h-1 | ①② | Spine surgery |
Yang 2013 | China | 40 — 60 | 18 | 19 | Loading dose of 0.7μg·kg-1 for 15min; maintenance dose of 0.6μg·kg-1·h-1 | ③ | Lumbar discectomy |
Moharram 2019 | Egypt | 18 — 65 | 30 | 30 | Maintenance dose of 0.5μg·kg-1·h-1 | ①②③ | Lumbar spine instrumentation surgery |
He 2018 | China | 75 — 90 | 30 | 30 | Loading dose of 0.5μg·kg-1 for 10min; maintenance dose of 0.4μg·kg-1·h-1 | ③ | Thoracic or lumbar fracture surgery |
Nikoubakht 2021 | Iran | 18 — 70 | 29 | 29 | Maintenance dose of 0.2μg·kg-1·h-1 | ①② | Posterior spine fusion |
Ray 2021 | India | 30 — 60 | 30 | 30 | Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.5μg·kg-1·h-1 | ①② | Spine surgery |
Liu 2022* | China | 18 — 60 | D1: 53 D2: 54 | 53 | D1: Maintenance dose of 0.5μg·kg-1·h-1 D2: Loading dose of 1μg·kg-1 for 10min; maintenance dose of 0.5μg·kg-1·h-1 | ① | Thoracic spinal decompression surgery |
Figure 3.
Forest plot of intraoperative hypotension. (A) overall analysis; (B) without a loading dose; (C) with a loading dose; (D) hypotension defined as MAP≤65mmHg or drop by more than 20% or SBP<90mmHg; (E) hypotension defined as MAP≤60mmHg or drop by more than 30%; (F) total intravenous anesthesia; (G) inhalation anesthesia; and (H) combined intravenous-inhalational anesthesia. NS: normal saline."
Figure 4.
Forest plot of intraoperative bradycardia. (A) overall analysis; (B) without a loading dose; (C) with a loading dose; (D) bradycardia defined as ≤60 beats/min or drop by more than 20%; (E) bradycardia defined as≤50 beats/min or drop by more than 30%; (F) total intravenous anesthesia; (G) inhalation anesthesia; (H) combined intravenous-inhalational anesthesia. NS: normal saline."
Figure 5.
Forest plots of intraoperative blood loss. (A) overall analysis; (B) without a loading dose; (C) with a loading dose; (D) in adults of all ages; (E) in the elderly; (F) total intravenous anesthesia; (G) inhalation anesthesia; (H) combined intravenous-inhalational anesthesia. NS: normal saline."
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