文献类型：期刊文献

英文题名：Dexmedetomidine effect on delirium in elderly patients undergoing general anesthesia A protocol for systematic review and meta-analysis

作者：Wang, Youran[1];Bu, Xinyi[2];Zhao, Na[3,4];Wang, Shuxia[3];Wang, Xiaoliang[2];Ge, Yali[2];Yi, Honggang[5]

第一作者：Wang, Youran

通信作者：Ge, YL[1]

机构：[1]Nanjing Med Univ, Nanjing Hosp 1, Dept Anesthesiol, Nanjing, Peoples R China;[2]Nanjing First Hosp, Dept Anesthesiol, 68 Changle Rd, Nanjing 210029, Peoples R China;[3]Gansu Univ Tradit Chinese Med, Sch Publ Hlth, Lanzhou, Peoples R China;[4]Gansu Univ Tradit Chinese Med, Ctr Evidence Based Med, Lanzhou, Peoples R China;[5]Nanjing Med Univ, Sch Publ Hlth, Dept Biostat, Nanjing, Peoples R China

第一机构：Nanjing Med Univ, Nanjing Hosp 1, Dept Anesthesiol, Nanjing, Peoples R China

通信机构：[1]corresponding author), Nanjing First Hosp, Dept Anesthesiol, 68 Changle Rd, Nanjing 210029, Peoples R China.

年份：2021

卷号：100

期号：48

外文期刊名：MEDICINE

收录：;Scopus(收录号：2-s2.0-85120896643);WOS:【SCI-EXPANDED(收录号:WOS:000725722600033)】；

语种：英文

外文关键词：dexmedetomidine; elderly patient; general anesthesia; postoperative delirium

摘要：Background: Delirium is a common postoperative complication. Many studies have found that dexmedetomidine is associated with a reduced incidence of postoperative delirium (POD). This meta-analysis aimed to analyze the effects of dexmedetomidine on POD incidence among elderly patients undergoing general anesthesia. Methods: We searched 4 electronic databases (i.e., Pubmed, Embase, Cochrane, and Web of Science) from inception to November 30, 2020, for randomized controlled trials that evaluated the effects of dexmedetomidine in preventing the occurrence of POD in elderly patients (aged >= 60 years). The study protocol was registered in PROSPERO (CRD42020192114). Results: 14 studies with 4173 patients showed that dexmedetomidine was significantly associated with a decreased POD incidence among elderly patients (relative risk [RR] = 0.58; 95% confidence interval [CI] = 0.44-0.76). The incidence of POD was significantly reduced in the noncardiac surgery group (RR 0.51; 95% CI 0.37-0.72), when dexmedetomidine was applied during the postoperative period (RR = 0.53; 95% CI = 0.40-0.70), and in patients received low-doses (RR = 0.54; 95% CI = 0.34-0.87) and normal-doses (RR = 0.59; 95% CI = 0.42-0.83). There were no significant differences in POD incidence in the cardiac surgery group (RR = 0.71; 95% CI = 0.45-1.11), and when dexmedetomidine was applied during the intra- (RR = 0.55; 95% CI = 0.29-1.01) or perioperative period (RR = 0.95; 95% CI = 0.64-1.40). Conclusions: Our meta-analysis suggests that dexmedetomidine may significantly reduce POD incidence in elderly noncardiac surgery patients and when applied during the postoperative period, in addition, both low- and normal-doses of dexmedetomidine may reduce POD incidence. However, its use in cardiac surgery patients and during the intra- or perioperative period may have no significant effects on POD incidence.