Table 1.
Relevant methodological features and characteristics of included studies
| Author | ASA | Age | Intervention | Premedication | Intraoperative anesthetics | Intraoperative analgesia | Postoperative analgesia | Timing of Dex | Bolus (µg/kg) | Continuous administration (µg/kg/h) | Primary outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ali 2013 | I–II | 2–6 years | Adenotonsillectomy | Midazolam | Sevoflurane | Dexamethasone + paracetamol | No | End of surgery | 0.3 | 0 | Agitation in PACU |
| Al-Zaben 2010 | I | 1–12 years | Hypospadias | 0 | Sevoflurane | Fentanyl | Morphine + paracetamol | After induction | 1 | 0.7 | Fentanyl, morphine, and paracetamol reduction |
| Erdil 2009 | I | 4–7 years | Adenoidectomy | 0 | Sevoflurane | Dexamethasone + paracetamol | Fentanyl | After induction | 0.5 | 0 | Agitation in PACU |
| Ghai 2015_1 | I–II | 1–6 years | Catact | Midazolam | Sevoflurane | Sub-tenon block + paracetamol | Fentanyl | After induction | 0.15 | 0 | Agitation in PACU |
| Ghai 2015_2 | I–II | 1–6 years | Catact | Midazolam | Sevoflurane | Sub-tenon block + paracetamol | Fentanyl | After induction | 0.3 | 0 | Agitation in PACU |
| Guler 2005 | I | 3–7 years | Adenotonsillectomy | 0 | Sevoflurane | Paracetamol | Fentanyl | End of surgery | 0.5 | 0 | Not defined |
| Hauber 2015 | I–III | 4–10 years | Adenotonsillectomy | 0 | Sevoflurane | Dexamethasone + morphine | Fentanyl | End of surgery | 0.5 | 0 | Agitation in PACU |
| Kim 2014 | I–III | 1–5 years | Strabism | 0 | Propofol + desflurane | Dexamethasone + fentanyl | Fentanyl | After induction | 0 | 0.2 | Agitation in PACU |
| Kim 2014 | I | 1–5 years | Orchidopexy | 0 | Sevoflurane | Caudal | Fentanyl | After induction | 1 | 0.1 | Decrease of sevoflurane ET concentration |
| Meng 2012_1 | I–II | 5–14 years | Adenoidectomy | Midazolam | Propofol + sevoflurane | Sufentanil + remifentanil | Fentanyl | After induction | 0.5 | 0.2 | Agitation in PACU |
| Meng 2012_2 | I–II | 5–14 years | Adenoidectomy | Midazolam | Propofol + sevoflurane | Sufentanil + remifentanil | Fentanyl | After induction | 1 | 0.4 | Not defined |
| Patel 2010 | II–III | 2–10 years | Adenotonsillectomy | 0 | Sevoflurane | Dexamethasone + paracetamol + fentanyl | Morphine | After induction | 2 | 0.7 | Rescue morphine in PACU |
| Pestieau 2011_1 | I–II | 6 months–6 years | Myringotomy | 0 | Sevoflurane | 0 | Paracetamol | After induction intranasal | 1 | 0 | Analgesic rescue |
| Pestieau 2011_2 | I–II | 6 months–6 years | Myringotomy | 0 | Sevoflurane | 0 | Paracetamol | After induction intranasal | 2 | 0 | Analgesic rescue |
| Sato 2010 | I–II | 1–9 years | Outpatient surgery | 0 | Sevoflurane | Paracetamol + NSAIDs | Fentanyl | After induction | 0.3 | 0 | Agitation in PACU |
| Shukry 2005 | I–II | 1–10 years | Outpatient surgery | 0 | Sevoflurane | Fentanyl | Morphine | After induction | 0 | 0.2 | Not defined |
| Soliman 2015 | I–II | 4–14 years | Adenotonsillectomy | 0 | Propofol + sevoflurane | Fentanyl + dexamethasone | Fentanyl + paracetamol | After induction | 0.5 | 0.2 | Agitation in PACU |
All studies compared Dex to inactive placebo. Studies with more than one Dex arm are displayed as author, name, year of publication_1 and author name, year of publication_2
ASA American Anesthesiologists Association, Dex dexmedetomidine, PACU postanethesia care unit, Paracetamol acetaminophen