Table 1.
Characteristics of RCTs included in meta-analysis
| Author Year, Country | Pooled age (Mean ± SD) | Males (N) | Intervention | Control | Induction regimen | Results | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Dexmed | N | Placebo | N | Hemodynamic | Adverse effects | Other | ||||
| Hussain 2019, India [16] | 34.5 ± 5.23 | 31 | Dexmed 2 μg /kg in 5 ml NS 30 min before induction and laryngoscopy | 35 | 5 ml NS | 35 | Fentanyl 2 μg /kg, Propofol 2 mg/kg, Vecuronium 0.1 mg/kg IV | Control group had statistically higher values of HR, SBP, DBP, MAP after intubation at all time intervals compared to dexmedetomidine group. | No adverse event reported in either group | |
| Misra 2021, India [12] | 39.15 ± 11.25 | 72 | Dexmed 1 μg /kg in 3–4 ml NS 30 min before induction and laryngoscopy | 60 | 3–4 ml NS | 60 | Ondansetron 4 mg, Midazolam 1 mg, Fentanyl 2 μg g/kg, propofol 10 mg boluses, vecuronium 0.15 mg/kg IV | After laryngoscopy and intubation, a significant trend of decrease in HR in dexmedetomidine group versus control group at all time points. No difference in SBP response between two groups. | Post-operative nausea and vomiting in 3/57 patients in dexmedetomidine group and 1/59 in normal saline group. | Induction dose of propofol, intraoperative fentanyl consumption and mean isoflurane requirements were significantly less in dexmedetomidine group versus control group. |
| Sheth 2021, India [17] | 29 ± 7.52 | 27 | Dexmed 1 μg /kg in 5 ml NS 10 min before shifting to OT | 25 | 5 ml NS | 25 | Glycopyrrolate 0.005 mg/kg IM, Fentanyl 2 μg/kg, Propofol 2 -2.5 mg/kg, atracurium 0.5 mg/kg IV | There was significantly reduced SBP, DBP, MAP at 1, 5 and 10 min after laryngoscopy and intubation in dexmedetomidine compared to control group. No difference between the two groups in terms of HR response. | No adverse event reported in either group | |
| Suryawanshi 2022, India [18] | 43.41 ± 13.21 | 31 | Dexmed 1 μg /kg in 3–4 ml NS 30 min before induction and laryngoscopy | 30 | 3–4 ml NS | 30 | Glycopyrrolate 0.004 mg/kg IV, Inj. Midazolam 0.02 mg/kg IV and Inj. Fentanyl 1- 2 μg /kg IV, propofol 2 mg/kg, Succinylcholine 2 μg/kg IV | HR, SBP, DBP, MAP significantly lower in dexmedetomidine group at all time points studied as compared to the control group. | No adverse event reported in either group | Lower post-operative sore throat in dexmedetomidine group. |
| Shrivastava 2022, India [19] | 38.97 ± 14.19 | 28 | Dexmed 1 μg /kg in 5 ml NS 30 min before induction and laryngoscopy | 50 | 5 ml NS | 50 |
Alprazolam 0.5 mg Midazolam 1 mg, Fentanyl 2 μg/kg, propofol 1–2 mg/kg, Vecuronium 0.1 mg/kg IV |
SBP, DBP, MAP and HR significantly lower in dexmedetomidine group compared to control group at 1, 5, 10 min. | No adverse event reported in either group | Nebulised dexmedetomidine has a dose sparing effect on induction dose of propofol. |
| Kaila 2023, India [20] | 35.43 ± 7.97 | 43 | Dexmed 1 μg/kg in 3–4 ml NS 30 min before induction and laryngoscopy | 40 | 3–4 ml NS | 40 | Metoclopramide 10 mg IV, Ondansetron 8 mg, Fentanyl 1–2 μg/kg, Propofol 2 mg/kg, Succinylcholine 100 μg IV | SBP, DBP, MAP significantly lower in dexmedetomidine group compared to control group at 2,4,6,8 min. | No adverse event reported in either group | |
HR Heart Rate, DBP Diastolic Blood Pressure, IV Intravenous, Kg Kilogram, MBP Mean Blood Pressure, mg Milligram, μg Microgram, SBP Systolic Blood Pressure