Gao Teng, Liu Xiaoxing, Liu Siyu, Liu Fanglin, Zhou Yuchen, Wang Shaoheng, Zeng Na, Bao Yanping, Wang Yuefu, Lu Lin
Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Huayuan Bei Road, Beijing, 100191, China.
Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100191, China.
Eur Arch Psychiatry Clin Neurosci. 2025 May 15. doi: 10.1007/s00406-025-02017-9.
Despite numerous studies of the anxiolytic effects of dexmedetomidine compared with those of other drugs or saline, the results have been inconsistent. Here we report a systematic review and meta-analysis to comprehensively evaluate the evidence of the anxiolytic effects of dexmedetomidine.
This research has been registered in the International Prospective Register of Systematic Reviews. The PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov database were searched for clinical trials that compared the anxiolytic effects of dexmedetomidine with those of a control group with valid anxiety scores from inception to December 29, 2024.
Overall, this systematic review and meta-analysis included 25 clinical studies with 2159 participants who underwent surgery. The primary outcome revealed that patients who were treated with dexmedetomidine had significantly lower anxiety scores than others did overall (MD = - 1.73, 95% CI = [ - 2.33, - 1.13], p < 0.00001, I = 86.5%). Dexmedetomidine was found to be more effective than benzodiazepines in relieving anxiety (MD = - 1.34, 95% CI = [ - 2.08, - 0.60], p = 0.0004, I = 83.3%). The secondary outcomes revealed no significant differences in satisfaction, pain level, sedation scores or the risk of postoperative nausea and vomiting between patients who were treated with dexmedetomidine and controls. However, the occurrence of bradycardia was more common in the dexmedetomidine groups.
Overall, this meta-analysis provided evidence of the potential of dexmedetomidine for relieving anxiety among patients who undergo surgery, with superior antianxiety effects compared with those of benzodiazepines.
尽管已有大量关于右美托咪定与其他药物或生理盐水相比的抗焦虑作用的研究，但其结果并不一致。在此，我们报告一项系统评价和荟萃分析，以全面评估右美托咪定抗焦虑作用的证据。
本研究已在国际系统评价前瞻性注册库注册。检索了PubMed、Embase、Cochrane图书馆、Web of Science和ClinicalTrials.gov数据库，查找从研究开始至2024年12月29日比较右美托咪定与具有有效焦虑评分的对照组抗焦虑作用的临床试验。
总体而言，这项系统评价和荟萃分析纳入了25项临床研究，共2159例接受手术的参与者。主要结果显示，接受右美托咪定治疗的患者总体焦虑评分显著低于其他患者（MD = -1.73，95%CI = [-2.33, -1.13]，p < 0.00001，I² = 86.5%）。发现右美托咪定在缓解焦虑方面比苯二氮䓬类药物更有效（MD = -1.34，95%CI = [-2.08, -0.60]，p = 0.0004，I² = 83.3%）。次要结果显示，接受右美托咪定治疗的患者与对照组在满意度、疼痛程度、镇静评分或术后恶心呕吐风险方面无显著差异。然而，心动过缓的发生在右美托咪定组中更为常见。
总体而言，这项荟萃分析提供了证据，表明右美托咪定在接受手术的患者中具有缓解焦虑的潜力，与苯二氮䓬类药物相比具有更好的抗焦虑效果。
