The Effectiveness of Dexmedetomidine on the Incidence of Vomiting after Pediatric Surgery with Sevoflurane: A Meta-Analysis of Clinical Trials

Since sevoflurane is one of the most effective anesthetic gases in the occurrence of nausea and vomiting after anesthesia in children, and on the other hand, due to the lack of a systematic review study regarding the effective role of dexmedetomidine in preventing this complication, the aim of Conducting this study was the effectiveness of dexmedetomidine on the occurrence of vomiting after surgery in children with sevoflurane.

The current study is a systematic review and meta-analysis, which was designed and implemented based on the steps of the PRISMA statement, randomized controlled trials that were published before the beginning of 2022, from Web of Science, Embase, PubMed, and Cochrane Library, Mag Iran and SID were searched and selected. Search keywords were "dexmedetomidine", "children", "anaesthesia", "vomiting" and "sevoflurane". Meta-analysis was performed using Stata software. The statistical results of the two-category data comparison were presented in the form of odds ratios (RRs) and 95% confidence intervals. Statistical results for continuous data were presented as standardized mean difference (SMD). Heterogeneity between included studies was checked using the χ2 test (significance level of the test α = 0.1) and the I2 index was used to quantify the heterogeneity of the results.

A total of 672 participants from 10 randomized clinical trial articles were reviewed; the results were P = 0.898 and I = 0%. It was shown that dexmedetomidine is associated with a decrease in the incidence of vomiting compared to placebo (CI = 0.24-0.60-OR 0.40: P = 0.001).

Nausea and vomiting after anesthesia is one of the common and unpleasant side effects that may endanger the patient's safety. Knowledge of the effects of different drugs effective in the occurrence of this complication can change the occurrence of nausea and vomiting after anesthesia; the results of this meta-analysis showed that dexmedetomidine reduces vomiting after anesthesia of children with soflurane.