Effect of dexmedetomidine supplementation for thoracoscopic surgery: a meta-analysis of randomized controlled trials

Introduction The efficacy of dexmedetomidine supplementation for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of dexmedetomidine for thoracoscopic surgery. Methods We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine supplementation on thoracoscopic surgery. This meta-analysis is performed using the random-effect model. Results Six RCTs involving 510 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, dexmedetomidine supplementation results in significantly reduced pain scores (SMD = - 1.50; 95% CI = - 2.63-- 0.37; P = 0.009), anesthetic consumption (SMD = - 3.91; 95% CI = - 6.76-- 1.05; P = 0.007), mean heart rate (SMD = - 0.41; 95% CI = - 0.65-- 0.18; P = 0.0007), and the risk ratio (RR) of ICU stay (RR = 0.39; 95% CI = 0.19-0.80; P = 0.01), but showed no obvious effect on mean blood pressure (SMD = - 0.07; 95% CI = - 0.45-0.31; P = 0.72) or hospital stay (SMD = - 0.61; 95% CI = - 1.30-0.08; P = 0.08). Conclusions Dexmedetomidine supplementation can substantially improve the analgesic efficacy for thoracoscopic surgery.