Table 4.
GRADE evidence profile.
| Quality assessment | № of patients | Effect | Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | DEX | Control | Relative (95% CI) | Absolute (95% CI) | ||
| Pain intensity at rest at 1 h postoperatively | ||||||||||||
| 10 | randomised trials | not serious | seriousa | not serious | not serious | none | 256 | 238 | — | MD 1.57 lower (1.94 lower to 1.2 lower) |
⨁⨁⨁◯ MODERATE |
IMPORTANT |
| Pain intensity on movement at 1 h postoperatively | ||||||||||||
| 3 | randomised trials | seriousb | seriousc | not serious | not serious | none | 90 | 70 | — | MD 1.71 lower (2.39 lower to 1.03 lower) |
⨁⨁◯◯ LOW |
IMPORTANT |
| Morphine-equivalents 0–24 h (mg) | ||||||||||||
| 6 | randomised trials | not serious | very seriousd | not serious | not serious | none | 151 | 153 | — | MD 8.54 lower (11.96 lower to 5.13 lower) |
⨁⨁◯◯ LOW |
IMPORTANT |
| Time to first analgesic request (min) | ||||||||||||
| 12 | randomised trials | not serious | very seriouse | not serious | not serious | none | 316 | 278 | — | MD 257.57 higher (209.86 higher to 305.28 higher) |
⨁⨁◯◯ LOW |
IMPORTANT |
| Postoperative nausea and vomiting | ||||||||||||
| 12 | randomised trials | not serious | not serious | not serious | very serious f | none | 10/316 (3.2%) | 6/278 (2.2%) | RR 1.37 (0.52 to 3.62) |
8 more per 1,000
(from 10 fewer to 57 more) |
⨁⨁◯◯ LOW |
IMPORTANT |
| Hypotension | ||||||||||||
| 12 | randomised trials | not serious | not serious | not serious | very serious g | none | 8/316 (2.5%) | 2/278 (0.7%) | RR 2.20 (0.67 to 7.23) |
9 more per 1,000
(from 2 fewer to 45 more) |
⨁⨁◯◯ LOW |
IMPORTANT |
| Bradycardia | ||||||||||||
| 12 | randomised trials | not serious | not serious | not serious | very serious h | none | 10/316 (3.2%) | 3/278 (1.1%) | RR 2.20 (0.81 to 5.97) |
13 more per 1,000
(from 2 fewer to 54 more) |
⨁⨁◯◯ LOW |
IMPORTANT |
DEX, dexmedetomidine; CI, confidence interval; MD, mean difference; RR, risk ratio.
aHeterogeneity: I2 = 89%.
bAll the trials were judged to be at unclear risk of bias.
cHeterogeneity: I2 = 86%.
dHeterogeneity: I2 = 95%.
eHeterogeneity: I2 = 93%.
fRR with 95% CI: 3.00 (0.13–69.52) for one trial and 7.00 (0.38–129.93) for another.
gRR with 95% CI: 3.00 (0.13–69.52), 3.00 (0.13–70.83), and 7.00 (0.38–129.93) for three trials.
hRR with 95% CI: 1.54 (0.07–36.11), 3.00 (0.13–69.52), and 3.00 (0.13–70.83) for three trials.