Efficacy of intranasal dexmedetomidine versus oral midazolam for premedication in pediatric patients: a meta-analysis / 中华麻醉学杂志

ABSTRACT

Objective:To systematically review and compare the efficacy of intranasal dexmedetomidine versus oral midazolam for premedication in the pediatric patients.Methods:PubMed, EMbase and Cochrane library were searched for all randomized controlled trials involving the efficacy of intranasal dexmedetomidine versus oral midazolam for premedication in the pediatric patients from inception to August 2019, with an English language restriction.Evaluation indexes included efficacy of preoperative sedation, acceptance of face mask for anesthesia, postoperative requirement for rescue analgesia, incidence of agitation during emergence and postoperative recovery time.The quality of the included trials was assessed according to the relevant criteria recommended in Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1.Meta-analysis was conducted using the Cochrane Collaboration′s Review Manager 5.3 software.Results:Ten randomized controlled trials involving 720 pediatric patients were included.Compared with oral midazolam group, the efficacy of preoperative sedation was better, the requirement for postoperative rescue analgesia was decreased ( P<0.01), and no significant differences were found in acceptance of face mask for anesthesia, incidence of agitation during emergence, and postoperative recovery time in intranasal dexmedetomidine group ( P>0.05). Conclusion:Intranasal dexmedetomidine provides better efficacy than oral midazolam when used for premedication in the pediatric patients.