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Abstract：
BACKGROUND: Intravenous dexmedetomidine (DEX) has been used to prevent emergence agitation (EA) in children. The aim of this meta-analysis was to evaluate whether DEX decreases EA incidence without augmenting oculocardiac reflex (OCR) in pediatric patients undergoing strabismus surgery.
METHODS: We searched PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library to collect the randomized controlled trials (RCTs) investigating the effects of intraoperative DEX in children undergoing strabismus surgery from inception to October 2019. Postoperative Pediatric Agitation and Emergence Delirium (PAED) score, postoperative EA, extubation or laryngeal mask airway (LMA) removal time, postanesthetic care unit (PACU) stay time, OCR, and postoperative vomiting (POV) were evaluated.
RESULTS: 11 RCTs including 801 patients were included in this study. Compared with control group, intravenous DEX significantly reduced postoperative PAED score (WMD, 3.05; 95% CI: -3.82 to -2.27, P = .017) and incidences of postoperative EA 69% (RR, 0.31; 95% CI: 0.17 to 0.55, P < .00) and POV (RR, 0.28; 95% CI: 0.13 to 0.61, P = .001). Furthermore, the use of DEX significantly delayed extubation or LMA removal time (WMD, 2.11; 95% CI: 0.25 to 3.97, P < .001). No significant difference was found in the incidence of ORC and PACU stay time.
CONCLUSIONS: Intravenous DEX reduced the incidences of EA without increasing OCR in pediatric patients undergoing strabismus surgery. Meanwhile, DEX infusion decreased the incidence of POV in children.
METHODS: We searched PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library to collect the randomized controlled trials (RCTs) investigating the effects of intraoperative DEX in children undergoing strabismus surgery from inception to October 2019. Postoperative Pediatric Agitation and Emergence Delirium (PAED) score, postoperative EA, extubation or laryngeal mask airway (LMA) removal time, postanesthetic care unit (PACU) stay time, OCR, and postoperative vomiting (POV) were evaluated.
RESULTS: 11 RCTs including 801 patients were included in this study. Compared with control group, intravenous DEX significantly reduced postoperative PAED score (WMD, 3.05; 95% CI: -3.82 to -2.27, P = .017) and incidences of postoperative EA 69% (RR, 0.31; 95% CI: 0.17 to 0.55, P < .00) and POV (RR, 0.28; 95% CI: 0.13 to 0.61, P = .001). Furthermore, the use of DEX significantly delayed extubation or LMA removal time (WMD, 2.11; 95% CI: 0.25 to 3.97, P < .001). No significant difference was found in the incidence of ORC and PACU stay time.
CONCLUSIONS: Intravenous DEX reduced the incidences of EA without increasing OCR in pediatric patients undergoing strabismus surgery. Meanwhile, DEX infusion decreased the incidence of POV in children.
摘要：
背景：静脉注射右美托咪定（DEX）已用于预防儿童出现躁动（EA）。这项荟萃分析的目的是评估DEX是否降低了接受斜视手术的儿科患者的EA发生率而不增加眼心反射（OCR）。
方法：我们搜索了PubMed，EMBASE,中国国家知识基础设施(CNKI),万芳,和Cochrane图书馆收集随机对照试验(RCT),调查从开始到2019年10月接受斜视手术的儿童术中DEX的效果.术后小儿躁动和谵妄(PAED)评分,术后EA,拔管或喉罩（LMA）的时间，麻醉后护理单元(PACU)停留时间，OCR,术后呕吐（POV）进行评估。
结果：本研究纳入11项RCTs，包括801例患者。与对照组相比,静脉注射DEX显着降低术后PAED评分（WMD，3.05；95%CI：-3.82至-2.27，P=0.017）和术后EA发生率69%（RR，0.31；95%CI：0.17至0.55，P<.00）和POV（RR，0.28；95%CI：0.13至0.61，P=.001）。此外，使用DEX显著延迟拔管或LMA拔除时间(WMD，2.11；95%CI：0.25至3.97，P<.001）。ORC和PACU停留时间的发生率没有显着差异。
结论：在接受斜视手术的儿科患者中，静脉DEX可降低EA的发生率，而不增加OCR。同时,DEX输注降低了儿童POV的发生率。
方法：我们搜索了PubMed，EMBASE,中国国家知识基础设施(CNKI),万芳,和Cochrane图书馆收集随机对照试验(RCT),调查从开始到2019年10月接受斜视手术的儿童术中DEX的效果.术后小儿躁动和谵妄(PAED)评分,术后EA,拔管或喉罩（LMA）的时间，麻醉后护理单元(PACU)停留时间，OCR,术后呕吐（POV）进行评估。
结果：本研究纳入11项RCTs，包括801例患者。与对照组相比,静脉注射DEX显着降低术后PAED评分（WMD，3.05；95%CI：-3.82至-2.27，P=0.017）和术后EA发生率69%（RR，0.31；95%CI：0.17至0.55，P<.00）和POV（RR，0.28；95%CI：0.13至0.61，P=.001）。此外，使用DEX显著延迟拔管或LMA拔除时间(WMD，2.11；95%CI：0.25至3.97，P<.001）。ORC和PACU停留时间的发生率没有显着差异。
结论：在接受斜视手术的儿科患者中，静脉DEX可降低EA的发生率，而不增加OCR。同时,DEX输注降低了儿童POV的发生率。
