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Table 1 Characteristics of RCTs included in meta-analysis

From: Nebulized dexmedetomidine for attenuating hemodynamic response to laryngoscopy and endotracheal intubation in adult patients undergoing surgeries under general anaesthesia: a systematic review and meta-analysis of randomized controlled trials

Author Year, Country

Pooled age (Mean ± SD)

Males (N)

Intervention

Control

Induction regimen

Results

Dexmed

N

Placebo

N

Hemodynamic

Adverse effects

Other

Hussain 2019, India [16]

34.5 ± 5.23

31

Dexmed 2 μg /kg in 5 ml NS 30 min before induction and laryngoscopy

35

5 ml NS

35

Fentanyl 2 μg /kg, Propofol 2 mg/kg, Vecuronium 0.1 mg/kg IV

Control group had statistically higher values of HR, SBP, DBP, MAP after intubation at all time intervals compared to dexmedetomidine group.

No adverse event reported in either group

 

Misra 2021, India [12]

39.15 ± 11.25

72

Dexmed 1 μg /kg in 3–4 ml NS 30 min before induction and laryngoscopy

60

3–4 ml NS

60

Ondansetron 4 mg, Midazolam 1 mg, Fentanyl 2 μg g/kg, propofol 10 mg boluses, vecuronium 0.15 mg/kg IV

After laryngoscopy and intubation, a significant trend of decrease in HR in dexmedetomidine group versus control group at all time points. No difference in SBP response between two groups.

Post-operative nausea and vomiting in 3/57 patients in dexmedetomidine group and 1/59 in normal saline group.

Induction dose of propofol, intraoperative fentanyl consumption and mean isoflurane requirements were significantly less in dexmedetomidine group versus control group.

Sheth 2021, India [17]

29 ± 7.52

27

Dexmed 1 μg /kg in 5 ml NS 10 min before shifting to OT

25

5 ml NS

25

Glycopyrrolate 0.005 mg/kg IM, Fentanyl 2 μg/kg, Propofol 2 -2.5 mg/kg, atracurium 0.5 mg/kg IV

There was significantly reduced SBP, DBP, MAP at 1, 5 and 10 min after laryngoscopy and intubation in dexmedetomidine compared to control group. No difference between the two groups in terms of HR response.

No adverse event reported in either group

 

Suryawanshi 2022, India [18]

43.41 ± 13.21

31

Dexmed 1 μg /kg in 3–4 ml NS 30 min before induction and laryngoscopy

30

3–4 ml NS

30

Glycopyrrolate 0.004 mg/kg IV, Inj. Midazolam 0.02 mg/kg IV and Inj. Fentanyl 1- 2 μg /kg IV, propofol 2 mg/kg, Succinylcholine 2 μg/kg IV

HR, SBP, DBP, MAP significantly lower in dexmedetomidine group at all time points studied as compared to the control group.

No adverse event reported in either group

Lower post-operative sore throat in dexmedetomidine group.

Shrivastava 2022, India [19]

38.97 ± 14.19

28

Dexmed 1 μg /kg in 5 ml NS 30 min before induction and laryngoscopy

50

5 ml NS

50

Alprazolam 0.5 mg

Midazolam 1 mg, Fentanyl 2 μg/kg, propofol 1–2 mg/kg, Vecuronium 0.1 mg/kg IV

SBP, DBP, MAP and HR significantly lower in dexmedetomidine group compared to control group at 1, 5, 10 min.

No adverse event reported in either group

Nebulised dexmedetomidine has a dose sparing effect on induction dose of propofol.

Kaila 2023, India [20]

35.43 ± 7.97

43

Dexmed 1 μg/kg in 3–4 ml NS 30 min before induction and laryngoscopy

40

3–4 ml NS

40

Metoclopramide 10 mg IV, Ondansetron 8 mg, Fentanyl 1–2 μg/kg, Propofol 2 mg/kg, Succinylcholine 100 μg IV

SBP, DBP, MAP significantly lower in dexmedetomidine group compared to control group at 2,4,6,8 min.

No adverse event reported in either group

 
  1. HR Heart Rate, DBP Diastolic Blood Pressure, IV Intravenous, Kg Kilogram, MBP Mean Blood Pressure, mg Milligram, μg Microgram, SBP Systolic Blood Pressure