Table 2.
GRADE assessment. Question: Is nebulized dexmedetomidine effective in blunting hemodynamic response to endotracheal intubation? Setting: Adult patients undergoing surgeries under general anaesthesia
| Certainty assessment | № of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | dexmedetomidine nebulization | placebo or no intervention | Relative (95% CI) | Absolute (95% CI) | ||
| HR at 1 min (assessed with: beats per minute) | ||||||||||||
| 5 | randomised trials | Seriousa | serious | not serious | not serious | publication bias strongly suspected | 200 | 200 | - | MD 8.59 beats/min lower (16.42 lower to 0.75 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing HR response to endotracheal intubation at 1 min. |
| HR at 2 min (assessed with: beats per minute) | ||||||||||||
| 4 | randomised trials | Seriousa | seriousb | not serious | not serious | publication bias strongly suspected | 165 | 165 | - | MD 13.48 beats/min lower (21.03 lower to 5.94 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing HR response to endotracheal intubation at 2 min. |
| HR at 5 min (assessed with: beats/minute) | ||||||||||||
| 5 | randomised trials | Seriousa | seriousb | not serious | not serious | publication bias strongly suspected | 200 | 200 | - | MD 7.16 beats/min lower (12.49 lower to 1.83 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing HR response to endotracheal intubation at 5 min. |
| SBP at 1 min (assessed with: mmHg) | ||||||||||||
| 5 | randomised trials | Seriousa | seriousb | not serious | not serious | publication bias strongly suspected | 200 | 200 | - | MD 12.48 mmHg lower (19.85 lower to 5.1 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing SBP response to endotracheal intubation at 1 min. |
| SBP at 2 min (assessed with: mmHg) | ||||||||||||
| 4 | randomised trials | Seriousa | seriousb | not serious | not serious | publication bias strongly suspected | 165 | 165 | - | MD 21 mmHg lower (30.41 lower to 11.6 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing SBP response to endotracheal intubation at 2 min. |
| SBP at 5 min (assessed with: mmHg) | ||||||||||||
| 5 | randomised trials | Seriousa | seriousb | not serious | not serious | publication bias strongly suspected | 200 | 200 | - | MD 9.25 mmHg lower (14.99 lower to 3.51 lower) |
⨁◯◯◯ Very low |
There is very low quality evidence that preoperative nebulized dexmedetomidine compared is effective in reducing SBP response to endotracheal intubation at 5 min. |
CI Confidence interval, MD Mean difference
aMultiple biases at individual study level
bHigh heterogeneity and variability in effect estimates