Sun Jing, Wang Duo, Zhao Yue, Bai Ying, Wang Shufang, Meng Chang, Miao Guobin, Liu Peng
Department of Critical Care Medicine, Emergency General Hospital, XiBaHe South Road 29, Chaoyang District, Beijing, 100028, PR China.
Department of general medicine, Ordos Central Hospital, Ordos School of Clinical Medicine, Inner Mongolia Medical University, 23 Yijinhuoluo West Street, Dongsheng District, Ordos, Inner Mongolia, 017000, PR China.
BMC Pharmacol Toxicol. 2025 Jan 17;26(1):8. doi: 10.1186/s40360-025-00841-2.
We conducted a meta-analysis to investigate the effect of dexmedetomidine on postoperative delirium in elderly orthopedic surgery patients.
A meta-analysis was conducted to identify randomized controlled trials of dexmedetomidine in elderly patients undergoing orthopedic surgery. The data was published on October 25, 2024. PubMed, Embase, and Cochrane Library databases were searched. Outcome measures included incidence of delirium, length of hospital stay, visual analogue scale, and postoperative complications. Estimates are expressed as relative risk (RR) or mean difference (MD) with a 95% confidence interval (CI). The publications were reviewed according to the guidelines of the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
This study was registered with INPLASY (number INPLASY2024110004). A total of 3159 patients were included in 9 randomized controlled trials. The results showed that dexmedetomidine exhibited a preventive effect on delirium compared with the control group in elderly patients after orthopedic surgery (RR: 0.55, 95% CI: 0.45-0.66, P < 0.01, I = 0%). Subgroup analysis suggested that dexmedetomidine was significantly different from saline(RR: 0.56; 95% CI: 0.44-0.73, P<0.01, I²=31%) and propofol(RR: 0.52; 95% CI: 0.39-0.70, P<0.01, I²=0%) in reducing postoperative delirium in elderly fracture patients. No statistically significant differences were observed in length of hospital stay, visual analogue scale, and postoperative complications (P > 0.05). Certainty of evidence for postoperative delirium was moderate.
Dexmedetomidine has been shown to have a protective effect on postoperative delirium in elderly patients following orthopedic surgery.
我们进行了一项荟萃分析，以研究右美托咪定对老年骨科手术患者术后谵妄的影响。
进行荟萃分析，以确定右美托咪定在老年骨科手术患者中的随机对照试验。数据于2024年10月25日发表。检索了PubMed、Embase和Cochrane图书馆数据库。观察指标包括谵妄发生率、住院时间、视觉模拟评分和术后并发症。估计值以相对风险（RR）或平均差（MD）表示，并带有95%置信区间（CI）。根据Cochrane手册和系统评价与荟萃分析的首选报告项目（PRISMA）指南对出版物进行审查。
本研究已在INPLASY注册（编号INPLASY2024110004）。9项随机对照试验共纳入3159例患者。结果显示，与对照组相比，右美托咪定对老年骨科手术后患者的谵妄具有预防作用（RR：0.55，95%CI：0.45 - 0.66，P < 0.01，I = 0%）。亚组分析表明，在降低老年骨折患者术后谵妄方面，右美托咪定与生理盐水（RR：0.56；95%CI：0.44 - 0.73，P < 0.01，I² = 31%）和丙泊酚（RR：0.52；95%CI：0.39 - 0.70，P < 0.01，I² = 0%）有显著差异。在住院时间、视觉模拟评分和术后并发症方面未观察到统计学显著差异（P > 0.05）。术后谵妄的证据确定性为中等。
右美托咪定已被证明对老年骨科手术后患者的术后谵妄具有保护作用。
