Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis

Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Alessandro De Cassai [verfasserIn] Nicolò Sella [verfasserIn] Federico Geraldini [verfasserIn] Francesco Zarantonello [verfasserIn] Tommaso Pettenuzzo [verfasserIn] Laura Pasin [verfasserIn] Margherita Iuzzolino [verfasserIn] Nicolò Rossini [verfasserIn] Elisa Pesenti [verfasserIn] Giovanni Zecchino [verfasserIn] Marina Munari [verfasserIn] Paolo Navalesi [verfasserIn] Annalisa Boscolo [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review

Übergeordnetes Werk:	In: Korean Journal of Anesthesiology - Korean Society of Anesthesiologists, 2017, 75(2022), 3, Seite 245-254
Übergeordnetes Werk:	volume:75 ; year:2022 ; number:3 ; pages:245-254

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.4097/kja.21359

Katalog-ID:	DOAJ042114411

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520			\|a Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.
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allfields	10.4097/kja.21359 doi (DE-627)DOAJ042114411 (DE-599)DOAJ177c07212b654e66898a3fe0822821c4 DE-627 ger DE-627 rakwb eng RD78.3-87.3 Alessandro De Cassai verfasserin aut Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology Nicolò Sella verfasserin aut Federico Geraldini verfasserin aut Francesco Zarantonello verfasserin aut Tommaso Pettenuzzo verfasserin aut Laura Pasin verfasserin aut Margherita Iuzzolino verfasserin aut Nicolò Rossini verfasserin aut Elisa Pesenti verfasserin aut Giovanni Zecchino verfasserin aut Marina Munari verfasserin aut Paolo Navalesi verfasserin aut Annalisa Boscolo verfasserin aut In Korean Journal of Anesthesiology Korean Society of Anesthesiologists, 2017 75(2022), 3, Seite 245-254 (DE-627)627614698 (DE-600)2557340-8 20057563 nnns volume:75 year:2022 number:3 pages:245-254 https://doi.org/10.4097/kja.21359 kostenfrei https://doaj.org/article/177c07212b654e66898a3fe0822821c4 kostenfrei http://ekja.org/upload/pdf/kja-21359.pdf kostenfrei https://doaj.org/toc/2005-6419 Journal toc kostenfrei https://doaj.org/toc/2005-7563 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 75 2022 3 245-254
spelling	10.4097/kja.21359 doi (DE-627)DOAJ042114411 (DE-599)DOAJ177c07212b654e66898a3fe0822821c4 DE-627 ger DE-627 rakwb eng RD78.3-87.3 Alessandro De Cassai verfasserin aut Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology Nicolò Sella verfasserin aut Federico Geraldini verfasserin aut Francesco Zarantonello verfasserin aut Tommaso Pettenuzzo verfasserin aut Laura Pasin verfasserin aut Margherita Iuzzolino verfasserin aut Nicolò Rossini verfasserin aut Elisa Pesenti verfasserin aut Giovanni Zecchino verfasserin aut Marina Munari verfasserin aut Paolo Navalesi verfasserin aut Annalisa Boscolo verfasserin aut In Korean Journal of Anesthesiology Korean Society of Anesthesiologists, 2017 75(2022), 3, Seite 245-254 (DE-627)627614698 (DE-600)2557340-8 20057563 nnns volume:75 year:2022 number:3 pages:245-254 https://doi.org/10.4097/kja.21359 kostenfrei https://doaj.org/article/177c07212b654e66898a3fe0822821c4 kostenfrei http://ekja.org/upload/pdf/kja-21359.pdf kostenfrei https://doaj.org/toc/2005-6419 Journal toc kostenfrei https://doaj.org/toc/2005-7563 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 75 2022 3 245-254
allfields_unstemmed	10.4097/kja.21359 doi (DE-627)DOAJ042114411 (DE-599)DOAJ177c07212b654e66898a3fe0822821c4 DE-627 ger DE-627 rakwb eng RD78.3-87.3 Alessandro De Cassai verfasserin aut Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology Nicolò Sella verfasserin aut Federico Geraldini verfasserin aut Francesco Zarantonello verfasserin aut Tommaso Pettenuzzo verfasserin aut Laura Pasin verfasserin aut Margherita Iuzzolino verfasserin aut Nicolò Rossini verfasserin aut Elisa Pesenti verfasserin aut Giovanni Zecchino verfasserin aut Marina Munari verfasserin aut Paolo Navalesi verfasserin aut Annalisa Boscolo verfasserin aut In Korean Journal of Anesthesiology Korean Society of Anesthesiologists, 2017 75(2022), 3, Seite 245-254 (DE-627)627614698 (DE-600)2557340-8 20057563 nnns volume:75 year:2022 number:3 pages:245-254 https://doi.org/10.4097/kja.21359 kostenfrei https://doaj.org/article/177c07212b654e66898a3fe0822821c4 kostenfrei http://ekja.org/upload/pdf/kja-21359.pdf kostenfrei https://doaj.org/toc/2005-6419 Journal toc kostenfrei https://doaj.org/toc/2005-7563 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 75 2022 3 245-254
allfieldsGer	10.4097/kja.21359 doi (DE-627)DOAJ042114411 (DE-599)DOAJ177c07212b654e66898a3fe0822821c4 DE-627 ger DE-627 rakwb eng RD78.3-87.3 Alessandro De Cassai verfasserin aut Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology Nicolò Sella verfasserin aut Federico Geraldini verfasserin aut Francesco Zarantonello verfasserin aut Tommaso Pettenuzzo verfasserin aut Laura Pasin verfasserin aut Margherita Iuzzolino verfasserin aut Nicolò Rossini verfasserin aut Elisa Pesenti verfasserin aut Giovanni Zecchino verfasserin aut Marina Munari verfasserin aut Paolo Navalesi verfasserin aut Annalisa Boscolo verfasserin aut In Korean Journal of Anesthesiology Korean Society of Anesthesiologists, 2017 75(2022), 3, Seite 245-254 (DE-627)627614698 (DE-600)2557340-8 20057563 nnns volume:75 year:2022 number:3 pages:245-254 https://doi.org/10.4097/kja.21359 kostenfrei https://doaj.org/article/177c07212b654e66898a3fe0822821c4 kostenfrei http://ekja.org/upload/pdf/kja-21359.pdf kostenfrei https://doaj.org/toc/2005-6419 Journal toc kostenfrei https://doaj.org/toc/2005-7563 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 75 2022 3 245-254
allfieldsSound	10.4097/kja.21359 doi (DE-627)DOAJ042114411 (DE-599)DOAJ177c07212b654e66898a3fe0822821c4 DE-627 ger DE-627 rakwb eng RD78.3-87.3 Alessandro De Cassai verfasserin aut Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension. bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology Nicolò Sella verfasserin aut Federico Geraldini verfasserin aut Francesco Zarantonello verfasserin aut Tommaso Pettenuzzo verfasserin aut Laura Pasin verfasserin aut Margherita Iuzzolino verfasserin aut Nicolò Rossini verfasserin aut Elisa Pesenti verfasserin aut Giovanni Zecchino verfasserin aut Marina Munari verfasserin aut Paolo Navalesi verfasserin aut Annalisa Boscolo verfasserin aut In Korean Journal of Anesthesiology Korean Society of Anesthesiologists, 2017 75(2022), 3, Seite 245-254 (DE-627)627614698 (DE-600)2557340-8 20057563 nnns volume:75 year:2022 number:3 pages:245-254 https://doi.org/10.4097/kja.21359 kostenfrei https://doaj.org/article/177c07212b654e66898a3fe0822821c4 kostenfrei http://ekja.org/upload/pdf/kja-21359.pdf kostenfrei https://doaj.org/toc/2005-6419 Journal toc kostenfrei https://doaj.org/toc/2005-7563 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 75 2022 3 245-254
language	English
source	In Korean Journal of Anesthesiology 75(2022), 3, Seite 245-254 volume:75 year:2022 number:3 pages:245-254
sourceStr	In Korean Journal of Anesthesiology 75(2022), 3, Seite 245-254 volume:75 year:2022 number:3 pages:245-254
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review Anesthesiology
isfreeaccess_bool	true
container_title	Korean Journal of Anesthesiology
authorswithroles_txt_mv	Alessandro De Cassai @@aut@@ Nicolò Sella @@aut@@ Federico Geraldini @@aut@@ Francesco Zarantonello @@aut@@ Tommaso Pettenuzzo @@aut@@ Laura Pasin @@aut@@ Margherita Iuzzolino @@aut@@ Nicolò Rossini @@aut@@ Elisa Pesenti @@aut@@ Giovanni Zecchino @@aut@@ Marina Munari @@aut@@ Paolo Navalesi @@aut@@ Annalisa Boscolo @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
hierarchy_top_id	627614698
id	DOAJ042114411
language_de	englisch
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Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. 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callnumber-first	R - Medicine
author	Alessandro De Cassai
spellingShingle	Alessandro De Cassai misc RD78.3-87.3 misc bradycardia misc cholecystecomy misc dexmedetomidine misc laparoscopy misc meta-analysis misc review misc Anesthesiology Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
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topic_title	RD78.3-87.3 Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis bradycardia cholecystecomy dexmedetomidine laparoscopy meta-analysis review
topic	misc RD78.3-87.3 misc bradycardia misc cholecystecomy misc dexmedetomidine misc laparoscopy misc meta-analysis misc review misc Anesthesiology
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title	Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
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title_full	Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
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author_browse	Alessandro De Cassai Nicolò Sella Federico Geraldini Francesco Zarantonello Tommaso Pettenuzzo Laura Pasin Margherita Iuzzolino Nicolò Rossini Elisa Pesenti Giovanni Zecchino Marina Munari Paolo Navalesi Annalisa Boscolo
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title_sort	preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
callnumber	RD78.3-87.3
title_auth	Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
abstract	Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.
abstractGer	Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.
abstract_unstemmed	Background While laparoscopic surgical procedures have various advantages over traditional open techniques, artificial pneumoperitoneum is associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an imidazole derivative that selectively binds to α2-receptors and has sedative and analgesic properties, can cause hypotension and bradycardia. Our primary aim was to assess the association between dexmedetomidine use and intraoperative bradycardia during laparoscopic cholecystectomy. Methods We performed a systematic review with a meta-analysis and trial sequential analysis using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, hemodynamics at intubation (systolic blood pressure, mean arterial pressure, heart rate), dose needed for induction of anesthesia, total anesthesia requirements (both hypnotics and opioids) throughout the procedure, and percentage of patients requiring postoperative analgesics and experiencing postoperative nausea and vomiting and/or shivering (O); randomized controlled trials (S). Results Fifteen studies were included in the meta-analysis (980 patients). Compared to patients that did not receive dexmedetomidine, those who did had a higher risk of developing intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of intraoperative anesthetics and had a lower incidence of postoperative nausea and vomiting. In the trial sequential analysis for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial. Conclusions Patients undergoing laparoscopic cholecystectomy who receive dexmedetomidine during tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.
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title_short	Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis
url	https://doi.org/10.4097/kja.21359 https://doaj.org/article/177c07212b654e66898a3fe0822821c4 http://ekja.org/upload/pdf/kja-21359.pdf https://doaj.org/toc/2005-6419 https://doaj.org/toc/2005-7563
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author2	Nicolò Sella Federico Geraldini Francesco Zarantonello Tommaso Pettenuzzo Laura Pasin Margherita Iuzzolino Nicolò Rossini Elisa Pesenti Giovanni Zecchino Marina Munari Paolo Navalesi Annalisa Boscolo
author2Str	Nicolò Sella Federico Geraldini Francesco Zarantonello Tommaso Pettenuzzo Laura Pasin Margherita Iuzzolino Nicolò Rossini Elisa Pesenti Giovanni Zecchino Marina Munari Paolo Navalesi Annalisa Boscolo
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Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis

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