Table 4 Effects of Dexmedetomidine on Analgesia, Sedation/Cognitive Dysfunction, Nausea/Vomiting, and PACU Discharge/Recovery Time
From: Perioperative Dexmedetomidine for outpatient cataract surgery: a systematic review
Study | Other Treatment Group(s) | Analgesia | Sedation or Cognitive Dysfunction | PONVa | PACUb Discharge or Recovery Time |
|---|---|---|---|---|---|
Abdalla [23] | saline | – | Increased sedation at 60 mins [mean BISc (SDd): 78.90 (4.99) vs 96.50 (2.09), P = 0.008] and 90 mins after starting infusion [93.00 (3.00) vs 96.35 (1.87), P = 0.047] | – | – |
Alhashemi [12] | midazolam | – | – | – | Increased recovery time [median time required to achieve Aldrete 10 (IQRe) 45 (36–54) mins vs 21 (10–32) mins, P < 0.01] |
Altiparmak [24] | remifentanil | Better analgesia at 10 mins [mean VRSf (SD): 0.67 (0.69) vs 1.78 (1.68), P = 0.016], 15 mins [mean VRS (SD): 0.57 (0.59) vs 1.15 (1.0), P = 0.008], 20 mins [mean VRS (SD): 0.52 (0.55) vs 1.16 (1.04), P = 0.006], 25 mins [mean VRS (SD): 0.54 (0.60) vs 1.12 (1.02), P = 0.015], 30 mins [mean VRS (SD): 0.54 (0.56) vs 1.13 (1.02), P = 0.023], and 35 mins [mean VRS (SD): 0.42 (0.50) vs 1.09 (0.99), P = 0.024] after start of surgery | Increased sedation at 1 min [mean OAA/Sg (SD): 3.45 (0.74) vs 3.82 (0.93), P = 0.012] and 45 mins [mean OAA/S (SD): 4.00 (0.46) vs 3.30 (1.18), P = 0.003] following start of surgery Increased sedation at 1 min [mean BIS (SD): 86.1 (14.07) vs 91.95 (7.72), P = 0.024], 5 mins [mean BIS (SD): 79.92 (8.03) vs 88.76 (7.23), P = 0.000], 10 mins [mean BIS (SD): 76.92 (6.30) vs 84.35 (8.59), P = 0.000], 15 mins [mean BIS (SD): 76.77 (5.94) vs 83.39 (7.29), P = 0.000], 20 mins [mean BIS (SD): 76.67 (6.17) vs 82.76 (6.81), P = 0.000], and 45 mins [mean BIS (SD): 87.3 (8.4) vs 94.25 (1.75), P = 0.017] after start of surgery | – | – |
Apan [11] | midazolam and saline | Better analgesia at 1 h postoperatively compared to midazolam [median VASh (range): 0 (0) vs 0 (13), P < 0.05] and saline [median VAS (range): 0 (0) vs 0 (12), P < 0.05]Better analgesia compared to midazolam at 2 h [median VAS (range): 0 (13) vs 8 (32), P < 0.05] and 3 h [median VAS (range): 5 (16) vs 13 (31), P < 0.05] postoperatively | Increased sedation compared to control group at 1 h [median 4-point sedation score (range): 2 (2) vs 1 (1), P < 0.05] and 3 h [median 4-point sedation score (range): 1 (1) vs 1 (1), P < 0.05] postoperatively | Not experienced by any patients | – |
Ayoglu [21] | no sedation | Lower perception of pain during block [NRSi (SD): 1.9 (0.5) vs 3.9 (0.6), P = 0.016] | Higher intraoperative RSSj scores [data values not reported, P < 0.05] | – | No statistically significant differences in Aldrete scores |
Dogan [13] | midazolam-fentanyl with topical analgesia or peribulbar block | Increased VPS [data values not reported, P = 0.001] Increased intraoperative analgesic requirement [data values not reported, P < 0.05] | No statistically significant differences in RSS scores between groups | Nausea and vomiting were observed in 1 patient ineach dexmedetomidine group | Increased time needed to achieve Aldrete 10 [data values not reported, P < 0.05] |
Erdurmus [14] | saline | Decreased pain perception [mean VPSk (SD): 1.23 (1.72) vs 3.64 (1.43), P < 0.001] | – | – | – |
Ghodki [15] | saline | No statistically significant difference (NRS) | Increased [mean RSS (SD): 2.67 (0.48) vs 1.56 (0.44), P < 0.0001] | – | No statistically significant difference in time required to achieve Aldrete 10 |
Kermany [10] | remifentanil | – | Better cognitive outcomes postoperatively for patients younger than 65-years [postoperative MMSEl: 26.3 vs 25.5, P = 0.03] and older than 65-years [postoperative MMSE: 26.1 vs 24.1, P = 0.0001] | – | – |
Muttu [16] | midazolam | No statistically significant difference [median VAS: 0.8 vs 1.1, P value not provided] | No persistent sedation in either group | – | – |
Na [17] | propofol-alfentanil | – | – | – | – |
Park [22] | remifentanil | – | No statistically significant differences between groups (BIS) Increased at 10 mins [data values not provided, P < 0.05] | – | Increased time needed to achieve RSS 2 [7.0–8.0 mins vs 1.9–1.7 mins, P value not provided] |
Virkilla [19] | placebo | – | No statistically significant difference between doses (VAS) | – | – |
Virkilla [20] | midazolam and placebo | No statistically significant differences in VAS associated with local anesthetic injection between treatment groups | No statistically significant differences compared to midazolam (VAS) Increased VAS compared to placebo [data not reported, P = 0.03] No statistically significant differences postoperatively between groups (VAS) | No statistically significant differences in nausea (VAS), and no patients vomited | – |
Yagan [18] | ketofolm | No statistically significant difference in VAS scores during the block and 1, 2, and 4 h postoperatively | Decreased sedation following drug administration [data not reported, P < 0.001] and after block [data not reported, P < 0.017] | – | Increased recovery time [mean time to achieve Aldrete 9 (SD): 24.9 (4.5) vs 16.1 (2.1), P < 0.001] |