Safety of dexmedetomidine-or remifentanil-based topical anesthesia for awake intubation: a meta-analysis / 中华麻醉学杂志

ABSTRACT

Objective To compare the safety of dexmedetomidine-versus remifentanil-based topical anesthesia for awake intubation.Methods PubMed,EMBASE,Web of Science,Cochrane Library,Chinese Biomedical Database,CNKI and Wanfang Database were searched from January 1990 to April 2016 for randomized controlled trials involving the safety of dexmedetomidine-and remifentanil-based topical anesthesia for awake intubation.The following data were extracted:the rate of successful intubation at first attempt and development of hypertension,hypotension,bradycardia,tachycardia,respiratory depression,bucking,body movement,sore throat,hoarseness and postsurgical memory of intubation.Meta-analysis was conducted using the RevMan 5.3 software.Results Ten studies involving 528 patients were included in this meta-analysis,and there were 262 cases in dexmedetonidine group and 266 cases in remifentanil group.Compared with remifentanil group,the incidence of respiratory depression and postsurgical memory of intubation were significantly decreased (P＜0.05),and no significant change was found in the rate of successful intubation at first attempt and incidence of hypertension,hypotension,bradycardia,tachycardia,bucking,body movement,sore throat and hoarseness in dexmedetomidine group (P＞0.05).Conclusion Dexmedetomidine-based topical anesthesia provides higher safety than remifentanil-based topical anesthesia when used for awake intubation.