Role of dexmedetomidine in the perioperative period of patients undergoing coronary artery bypass graft surgery: A meta-analysis / 解放军医学杂志

ABSTRACT

Objective To assess the value of dexmedetomidine during perioperative period for coronary artery bypass grafting (CABG). Methods Electronic databases including Cochrane library, PubMed, EMBase, Highwire, Medline, CBM, CNKI and CSJD were searched. A meta-analysis of all randomized controlled trials (RCTs) for comparing the effect of dexmedetomidine with that of control in perioperative period of CABG was performed. Study selection and meta-analysis were conducted according to the protocol of Cochrane Handbook for systematic reviews. Data were extracted from these trials by 3 reviewers independently and analyzed by RevMan 5.0 software. Results A total of 10 RCTs including 562 patients were assessed in this study. Compared with control group, mechanical ventilation time (RR=-2.26, 95%CI -4.44–-0.07, P=0.04), ventricular tachyarrhythmias (RR=0.21, 95%CI 0.09-0.53, P=0.0009), and incidence of delirium (RR=0.53, 95%CI 0.29-0.98, P=0.04) were significantly decreased in dexmedetomidine group. No difference was found between the two groups in intensive care unit stay time (RR=-0.27, 95%CI -0.56-0.02, P=0.06), mortality rate (RR=0.77, 95%CI 0.20-3.05, P=0.71), incidence of bradycardia (RR=1.46, 95%CI 0.88-2.44, P=0.14), hypotension (RR=1.55, 95%CI 0.98-2.46, P=0.06), application of vasoactive agents (RR=0.99, 95%CI 0.56-1.76, P=0.98), and atrial-fibrillation (RR=0.82, 95%CI 0.58-1.17, P=0.27). Conclusion Use of dexmedetomidine could decrease mechanical ventilation time, incidence of ventricular tachyarrhythmia and delirium, and there was no increase in complications, thereby improving the prognosis of patients undergoing CABG surgery.