Meta Analysis Of The Effect Of Dexmedetomidine On Postoperative Delirium In Elderly Patients With Non Cardiac Surgery

Objective:To explore the effect of dexmedetomidine on postoperative delirium after non-cardiac surgery in elderly patients by Meta-analysis.Methods:the computer searched PubMed,Cochrane Library,CNKI,CBM,VIP,Wanfang database,and manual searched periodicals in library for the database from the retrieval period to December 2017.Randomized clinical trials(RCTS)that meet the effects of dexmedetomidine on postoperative delirium in elderly patients with non-cardiac surgery were collected.literature data and quality evaluation method of extraction were screened by two researchers independently according to the inclusion and exclusion criteria.The RevMan5.3 software was used to analyze the standard documents by Meta.Results:A total of 18 RCTs and 2526 elderly patients were included.The results of Meta analysis showed that dexmedetomidine on postoperative delirium was significantly lower than the normal saline(OR=0.37,95%CI:0.26~0.52,P<0.05);the first?second and third postoperative day of delirium incidence was significantly lower than the saline group[(OR=0.27,95%CI:0.13~0.57,P=0.0005)?(OR=0.29,95%CI:0.14~0.59,P=0.0006)?(OR=0.28,95%CI:0.10~0.78,P=0.01)].Dexmedetomidine group and saline group on recovery time was not statistically significant(MD=-0.10,95%CI :-7.63 ~ 7.43,P=0.98),dexmedetomidine group and saline group on intubation time was not statistically significant(MD=-0.39,95%CI:-6.92~6.15,P=0.91),Compared with normal saline,dexmedetomidine on bradycardia and hypotension were significantly lower(OR=1.39,95%CI:1.06~1.83,P=0.02)?(OR=1.33,95%CI,: 1.05 ~ 1.69,P=0.02).Compared with normal saline,dexmedetomidine did not increase the incidence of postoperative nausea andvomiting(OR=0.69,95%CI:0.40~1.18,P=0.17).Conclusion:The present Meta-analysis indicate that Perioperative application of dexmedetomidine can not only reduce the incidence of postoperative delirium,but also not delay the postoperative recovery time and intubation time,and do not increase the incidence of postoperative nausea and vomiting in elderly patients,However,dexmedetomidine can increase the incidence of hypotension and bradycardia risk in elderly patients.