Dexmedetomidine reduces postoperative cognitive and behavioral dysfunction in adults submitted to general anesthesia for non-cardiac surgery: meta-analysis of randomized clinical trials.

Autor:	Govêia CS; Universidade de Brasília, Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasília, DF, Brazil; Sociedade Brasileira de Anestesiologia, Brazil; Universidade de Brasília, Brasília, DF, Brazil., Miranda DB; Universidade Federal de Goiás, Instituto de Medicina Tropical e Saúde Pública, Goiânia, GO, Brazil. Electronic address: denismarmiranda@hotmail.com., Oliveira LVB; Universidade de Brasília, Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasília, DF, Brazil., Praxedes FB; Universidade de Brasília, Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasília, DF, Brazil., Moreira LG; Universidade de Brasília, Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasília, DF, Brazil; Sociedade Brasileira de Anestesiologia, Brazil., Guimarães GMN; Universidade de Brasília, Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasília, DF, Brazil; Sociedade Brasileira de Anestesiologia, Brazil; Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of anesthesiology (Elsevier) [Braz J Anesthesiol] 2021 Jul-Aug; Vol. 71 (4), pp. 413-420. Date of Electronic Publication: 2021 Feb 19.
DOI:	10.1016/j.bjane.2021.02.020
Abstrakt:	Introduction and Objectives: Dexmedetomidine (DEX) has been associated with a decrease in postoperative cognitive and behavioral dysfunction in patients submitted to general anesthesia, whether inhalation or total intravenous anesthesia. Consequently, the DEX effects on postoperative agitation and delirium in patients submitted to general anesthesia for non-cardiac surgery have been investigated. Method: A systematic review and meta-analysis of randomized and double-blind clinical trials (RCTs) was undertaken assessing adults submitted to elective procedures under general anesthesia receiving DEX or placebo. The search included articles published in English in the Pubmed and Web of Science databases using keywords such as dexmedetomidine, delirium, and agitation. Duplicate publications, studies involving cardiac surgery or using active control (other than saline solution) were included. A random effects model was adopted using the DerSimonian-Laird method and estimate of Odds Ratio (OR) for dichotomous variables, and weighted mean difference for continuous variables, with their respective 95% Confidence Intervals (95% CI). Results: Of the 484 articles identified, 15 were selected comprising 2,183 patients (1,079 and 1,104 patients in the DEX and control group, respectively). The administration of DEX was considered a protective factor for postoperative cognitive and behavioral dysfunction (OR=0.36; 95% CI 0.23-0.57 and p<0.001), regardless of the anesthesia technique used. Conclusion: Dexmedetomidine administration reduced by at least 43% the likelihood of postoperative cognitive and behavioral dysfunction in adult patients submitted to general anesthesia for non-cardiac surgery. (Copyright © 2021. Published by Elsevier Editora Ltda.)
Databáze:	MEDLINE
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