Table 3.
Summary of findings
| Quality assessment | Summary of findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Outcome | Limitations | Inconsistency | Indirectness | Imprecision | Publication Bias | Number of Patients in DEX Group |
Number of Patients in Control Group | Mean Difference or Relative Risk (95% CI) |
P Value for Overall Effect | Quality of Evidence (GRADE) |
| DOA when combined with short−/intermediate-acting LA (min) | Concealment not clear in most studies | Serious inconsistency | Moderate indirectness | No serious imprecision | 7 studies missing for our primary outcome | 140 | 135 | 126.01(44.22 to 207.81) | 0.003 | Very low quality |
| DOA when combined with long-acting LA (min) | Concealment not clear in most studies | Serious inconsistency | Moderate indirectness | No serious imprecision | 7 studies missing for our primary outcome | 1411 | 1402 | 305.52(271.81 to 339.22) | <0.00001 | Very low quality |
| Pain score at rest at 12 h postoperatively (analog scale, 0–10) | Concealment not clear in most studies | Serious inconsistency | No serious indirectness | Moderate imprecision | 7 studies missing for our primary outcome | 346 | 341 | −1.57(−1.91 to −1.23) | <0.00001 | Very low quality |
| Pain score at rest at 24 h postoperatively (analog scale, 0–10) | Concealment not clear in most studies | Serious inconsistency | No serious indirectness | Moderate imprecision | 7 studies missing for our primary outcome | 321 | 314 | −0.60(−1.61 to 0.42) | 0.25 | Very low quality |
| Cumulative IV morphine consumption at 24 h postoperatively (mg) | Concealment not clear in most studies | Serious inconsistency | No serious indirectness | Moderate imprecision | 7 studies missing for our primary outcome | 256 | 250 | −5.03(−7.54 to −2.51) | <0.0001 | Very low quality |
| Rate of bradycardia | 28 of 57 trials reported that outcome | Serious inconsistency | No serious indirectness | Serious imprecision | 7 studies missing for our primary outcome | 862 | 852 | 0.13(0.06 to 0.20) | 0.0002 | Very low quality |
| Rate of hypotension | 26 of 57 trials reported that outcome | Serious inconsistency | No serious indirectness | Serious imprecision | 7 studies missing for our primary outcome | 802 | 789 | 0.05(0.01 to 0.09) | 0.007 | Very low quality |
Abbreviations: DEX, dexmedetomidine; CI, confidence interval; GRADE, Grades of Recommendation, Assessment, Development, and Evaluation; DOA, duration of analgesia; LA, local anesthetic; IV, intravenous