Meta-analysis of Efficacy and Safety of Intranasal Administration of Dexmedetomidine versus Oral Administration of Chloral Hydrate for Programmed Sedation in Children / 中国药房

ABSTRACT

OBJECTIVE：To systematically evaluat e the efficacy and safety of intranasal administration of dexmedetomidine versus oral administration of chloral hydrate for programmed sedation in children. METHODS ：Retrieved from Cochrane Library ，PubMed， Embase，CBM，CNKI and Wanfang database ，randomized controlled trials （RCTs）about intranasal administration of dexmedetomidine （trial group ）versus oral administration of chloral hydrate （control group ）for programmed sedation in children were collected. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of the included literatures after literature screening and data extraction，and Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS ：A total of 8 RCTs were included ， with a total of 1 413 children. Meta-analysis showed that the sedation success rate [RR ＝1.13，95％CI（1.02，1.25），P＝0.02]，sedation onset time [MD ＝－1.07，95％CI（－1.82，－0.31），P＝0.006]，sedation duration [MD ＝－8.25，95％CI（－14.02，－2.47），P＝ 0.005]，wake-up time [MD ＝－9.63，95％CI（－15.40，－3.86），P＝0.001]，the incidence of nausea and vomiting [RR ＝0.05，95％CI （0.02，0.14），P＜0.000 01] in the trial group were significantly better than those in control group. There was no statistical significance in the incidence of SpO 2＜95％ [RR＝0.60，95％CI（0.24，1.54），P＝0.29]，incidence of hypotension [RR ＝1.18，95％CI（0.51， 2.74），P＝0.71]，incidence of bradycardia [RR ＝1.33，95％CI（0.18，9.88），P＝0.78] between 2 groups. CONCLUSIONS ：Intranasal administration of dexmedetomidine has better efficacy than oral administration of chloral hydrate for programmed sedation in children with good safety.