Dexmedetomidine in pediatric tonsillectomy: a systematic review with meta-analysis

Stamer UM, Bernhart K, Lehmann T, et al. “Desire for more analgesic treatment”: pain and patient-reported outcome after pediatric tonsillectomy and appendectomy. Br J Anaesth 2021; 126: 1182–91. https://doi.org/10.1016/j.bja.2020.12.047

Article  PubMed  Google Scholar 

Stewart DW, Ragg PG, Sheppard S, Chalkiadis GA. The severity and duration of postoperative pain and analgesia requirements in children after tonsillectomy, orchidopexy, or inguinal hernia repair. Pediatr Anesth 2012; 22: 136–43. https://doi.org/10.1111/j.1460-9592.2011.03713.x

Article  Google Scholar 

Von Ungern-Sternberg BS, Davies K, Hegarty M, Erb TO, Habre W. The effect of deep vs. awake extubation on respiratory complications in high-risk children undergoing adenotonsillectomy: a randomized controlled trial. Eur J Anaesthesiol 2013; 30: 529–36. https://doi.org/10.1097/eja.0b013e32835df608

Von Ungern-Sternberg BS, Sommerfield D, Slevin L, Drake-Brockman TF, Zhang G, Hall GL. Effect of albuterol premedication vs placebo on the occurrence of respiratory adverse events in children undergoing tonsillectomies: the REACT randomized clinical trial. JAMA Pediatr 2019; 173: 527–33. https://doi.org/10.1001/jamapediatrics.2019.0788

Article  Google Scholar 

Patel HH, Straight CE, Lehman EB, Tanner M, Carr MM. Indications for tonsillectomy: a 10-year retrospective review. Int J Pediatr Otorhinolaryngol 2014; 78: 2151–5. https://doi.org/10.1016/j.ijporl.2014.09.030

Article  PubMed  Google Scholar 

Templeton TW, Sommerfield D, Hii J, Sommerfield A, Matava CT, von Ungern-Sternberg BS. Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in pediatric anesthesia—part 2: anesthesia-related risk and treatment options. Pediatr Anesth 2022; 32: 217–27. https://doi.org/10.1111/pan.14376

Article  Google Scholar 

Banatwala UE, Syed AR, Ain NU, et al. Assessing the efficacy of celecoxib after tonsillectomy and/or adenoidectomy: a systematic review and meta-analysis of randomized controlled trials. Clin Otolaryngol 2024; 49: 578–87. https://doi.org/10.1111/coa.14177

Article  PubMed  Google Scholar 

Aldamluji N, Burgess A, Pogatzki-Zahn E, Raeder J, Beloeil H. PROSPECT guideline for tonsillectomy: systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 2021; 76: 947–61. https://doi.org/10.1111/anae.15299

Article  CAS  PubMed  Google Scholar 

Albornoz AE, Rana M, Englesakis M, et al. Perioperative clinical practice recommendations for pediatric tonsillectomy: a systematic review. Can J Anesth 2024; 71: 187–200. https://doi.org/10.1007/s12630-023-02668-z

Article  PubMed  Google Scholar 

Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg 2000; 90: 699–705. https://doi.org/10.1097/00000539-200003000-00035

Article  CAS  PubMed  Google Scholar 

Zhu A, Benzon HA, Anderson TA. Evidence for the efficacy of systemic opioid-sparing analgesics in pediatric surgical populations: a systematic review. Anesth Analg 2017; 125: 1569–87. https://doi.org/10.1213/ane.0000000000002434

Article  CAS  PubMed  Google Scholar 

Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg 2010; 111: 1004–10. https://doi.org/10.1213/ane.0b013e3181ee82fa

Article  CAS  PubMed  Google Scholar 

Yang X, Hu Z, Peng F, et al. Effects of dexmedetomidine on emergence agitation and recovery quality among children undergoing surgery under general anesthesia: a meta-analysis of randomized controlled trials. Front Pediatr 2020; 8: 550828. https://doi.org/10.3389/fped.2020.580226

Article  Google Scholar 

Higgins JP, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 6.3; 2022. Available from URL: www.training.cochrane.org/handbook (accessed March 2025).

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. J Clin Epidemiol 2021; 134: 178–89. https://doi.org/10.1016/j.jclinepi.2021.03.001

Article  PubMed  Google Scholar 

Nielsen S, Degenhardt L, Hoban B, Gisev N. A synthesis of oral morphine equivalents (OME) for opioid utilization studies. Pharmacoepidemiol Drug Saf 2016; 25: 733–7. https://doi.org/10.1002/pds.3945

Article  PubMed  Google Scholar 

Regli A, von Ungern-Sternberg BS. Diagnosis and management of respiratory adverse events in the operating room. Curr Anesthesiol Rep 2015; 5: 156–67. https://doi.org/10.1007/s40140-015-0103-z

Article  Google Scholar 

Lerman J, Ingelmo P. Emergence delirium in children: do the studies reflect reality? Pediatr Anesth 2024; 34: 493–4. https://doi.org/10.1111/pan.14870

Article  CAS  Google Scholar 

Watcha MF, Lee AD, Medellin E, Felberg MT, Bidani SA. Clinical use of the pictorial Baxter Retching Faces Scale for the measurement of postoperative nausea in children. Anesth Analg 2019; 128: 1249–55. https://doi.org/10.1213/ane.0000000000003850

Article  CAS  PubMed  Google Scholar 

Trottier ED, Ali S, Doré-Bergeron MJ, Chauvin-Kimoff L. Best practices in pain assessment and management for children. Paediatr Child Health 2022; 27: 429–48. https://doi.org/10.1093/pch/pxac048

Article  PubMed  PubMed Central  Google Scholar 

Sterne JA, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomized trials. Br Med J 2019; 366: I4898. https://doi.org/10.1136/bmj.l4898

Article  Google Scholar 

Zhang Y, Alonso-Coello P, Guyatt GH, et al. GRADE guidelines: 19. assessing the certainty of evidence in the importance of outcomes or values and preferences—risk of bias and indirectness. J Clin Epidemiol 2019; 111: 94–104. https://doi.org/10.1016/j.jclinepi.2018.01.013

Zhang Y, Coello PA, Guyatt GH, et al. GRADE guidelines: 20. assessing the certainty of evidence in the importance of outcomes or values and preferences—inconsistency, imprecision, and other domains. J Clin Epidemiol 2019; 111: 83–93. https://doi.org/10.1016/j.jclinepi.2018.05.011

Santesso N, Glenton C, Dahm P, et al. GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. J Clin Epidemiol 2020; 119: 126–35. https://doi.org/10.1016/j.jclinepi.2019.10.014

Article  PubMed  Google Scholar 

Rücker G, Cates CJ, Schwarzer G. Methods for including information from multi-arm trials in pairwise meta-analysis. Res Synth Methods 2017; 8: 392–403. https://doi.org/10.1002/jrsm.1259

Article  PubMed  Google Scholar 

Wong I, St John-Green C, Walker SM. Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Pediatr Anesth 2013; 23: 475–95. https://doi.org/10.1111/pan.12163

Article  Google Scholar 

Blaudszun G, Lysakowski C, Elia N, Tramè MR. Effect of perioperative systemic α2-agonists on postoperative morphine consumption and pain intensity: a systematic review and meta-analysis of randomized controlled trials. Anesthesiology 2012; 116: 1312–27. https://doi.org/10.1097/aln.0b013e31825681cb

Article  CAS  PubMed  Google Scholar 

Schnabel A, Meyer-Frießem CH, Reichl SU, Zahn PK, Pogatzki-Zahn EM. Is intraoperative dexmedetomidine a new option for postoperative pain treatment? A meta-analysis of randomized controlled trials. Pain 2013; 154: 1140–9. https://doi.org/10.1016/j.pain.2013.03.029

Article  CAS  PubMed  Google Scholar 

Liu Y, Liang F, Liu X, Shao X, Jiang N, Gan X. Dexmedetomidine reduces perioperative opioid consumption and postoperative pain intensity in neurosurgery: a meta-analysis. J Neurosurg Anesthesiol 2018; 30: 146–55. https://doi.org/10.1097/ana.0000000000000403

Article  PubMed  Google Scholar 

Schnabel A, Reichl SU, Poepping DM, Kranke P, Pogatzki-Zahn EM, Zahn PK. Efficacy and safety of intraoperative dexmedetomidine for acute postoperative pain in children: a meta-analysis of randomized controlled trials. Pediatr Anesth 2013; 23: 170–9. https://doi.org/10.1111/pan.12030

Article  Google Scholar 

Franz AM, Martin LD, Liston DE, Latham GJ, Richards MJ, Low DK. In pursuit of an opioid-free pediatric ambulatory surgery center: a quality improvement initiative. Anesth Analg 2021; 132: 788–97. https://doi.org/10.1213/ane.0000000000004774

Article  CAS  PubMed  Google Scholar 

Bellon M, Le Bot A, Michelet D, et al. Efficacy of intraoperative dexmedetomidine compared with placebo for postoperative pain management: a meta-analysis of published studies. Pain Ther 2016; 5: 63–80. https://doi.org/10.1007/s40122-016-0045-2

Article  PubMed  PubMed Central  Google Scholar 

Na HS, Kim SY, Park JI, Lee S, Hwang JW, Shin HJ. The effect of intranasal dexmedetomidine administration on emergence agitation or delirium in pediatric patients after general anesthesia: a meta-analysis of randomized controlled trials. Pediatr Anesth 2023; 33: 636–46. https://doi.org/10.1111/pan.14689

Article  Google Scholar 

Alassaf HM, Sobahi AM, Alshahrani NS. The efficacy and safety of dexmedetomidine in preventing emergence delirium in pediatric patients following ophthalmic surgery: a systematic review and meta-analysis of randomized controlled trials. J Anesth Analg Crit Care 2022; 2: 48. https://doi.org/10.1186/s44158-022-00079-y

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