Intravenous dexmedetomidine for delirium prevention in elderly patients following orthopedic surgery: a meta-analysis of randomized controlled trials.

IF 2.8 3区 医学 Q2 PHARMACOLOGY & PHARMACY BMC Pharmacology & Toxicology Pub Date : 2025-01-17 DOI:10.1186/s40360-025-00841-2
Jing Sun, Duo Wang, Yue Zhao, Ying Bai, Shufang Wang, Chang Meng, Guobin Miao, Peng Liu
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Abstract

Objectives: We conducted a meta-analysis to investigate the effect of dexmedetomidine on postoperative delirium in elderly orthopedic surgery patients.

Methods: A meta-analysis was conducted to identify randomized controlled trials of dexmedetomidine in elderly patients undergoing orthopedic surgery. The data was published on October 25, 2024. PubMed, Embase, and Cochrane Library databases were searched. Outcome measures included incidence of delirium, length of hospital stay, visual analogue scale, and postoperative complications. Estimates are expressed as relative risk (RR) or mean difference (MD) with a 95% confidence interval (CI). The publications were reviewed according to the guidelines of the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results: This study was registered with INPLASY (number INPLASY2024110004). A total of 3159 patients were included in 9 randomized controlled trials. The results showed that dexmedetomidine exhibited a preventive effect on delirium compared with the control group in elderly patients after orthopedic surgery (RR: 0.55, 95% CI: 0.45-0.66, P < 0.01, I2 = 0%). Subgroup analysis suggested that dexmedetomidine was significantly different from saline(RR: 0.56; 95% CI: 0.44-0.73, P<0.01, I²=31%) and propofol(RR: 0.52; 95% CI: 0.39-0.70, P<0.01, I²=0%) in reducing postoperative delirium in elderly fracture patients. No statistically significant differences were observed in length of hospital stay, visual analogue scale, and postoperative complications (P > 0.05). Certainty of evidence for postoperative delirium was moderate.

Conclusions: Dexmedetomidine has been shown to have a protective effect on postoperative delirium in elderly patients following orthopedic surgery.

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静脉注射右美托咪定预防骨科术后老年患者谵妄:一项随机对照试验的荟萃分析
目的:我们进行荟萃分析,探讨右美托咪定对老年骨科手术患者术后谵妄的影响。方法:通过meta分析确定右美托咪定在老年骨科手术患者中的随机对照试验。该数据于2024年10月25日公布。检索PubMed、Embase和Cochrane图书馆数据库。结果测量包括谵妄的发生率、住院时间、视觉模拟量表和术后并发症。估计值表示为相对风险(RR)或平均差异(MD), 95%置信区间(CI)。根据Cochrane手册和系统评价和荟萃分析首选报告项目(PRISMA)的指南对出版物进行审查。结果:本研究已在INPLASY注册(编号INPLASY2024110004)。9项随机对照试验共纳入3159例患者。结果显示,与对照组相比,右美托咪定对老年骨科术后谵妄有预防作用(RR: 0.55, 95% CI: 0.45-0.66, P < 2 = 0%)。亚组分析显示右美托咪定与生理盐水差异有统计学意义(RR: 0.56;95% ci: 0.44-0.73, p 0.05)。术后谵妄证据的确定性为中等。结论:右美托咪定已被证明对老年骨科术后谵妄患者有保护作用。
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来源期刊
BMC Pharmacology & Toxicology
BMC Pharmacology & Toxicology PHARMACOLOGY & PHARMACYTOXICOLOGY&nb-TOXICOLOGY
CiteScore
4.80
自引率
0.00%
发文量
87
审稿时长
12 weeks
期刊介绍: BMC Pharmacology and Toxicology is an open access, peer-reviewed journal that considers articles on all aspects of chemically defined therapeutic and toxic agents. The journal welcomes submissions from all fields of experimental and clinical pharmacology including clinical trials and toxicology.
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