Open Access

Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: A meta‑analysis of randomized controlled trials with trial sequential analysis

  • Authors:
    • Yong Tang
    • Juan Meng
    • Xinxian Zhang
    • Jiong Li
    • Qiang Zhou
  • View Affiliations

  • Published online on: July 8, 2019     https://doi.org/10.3892/etm.2019.7751
  • Pages: 1775-1785
  • Copyright: © Tang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Dexmedetomidine and propofol are commonly used sedative agents in pediatric patients undergoing magnetic resonance imaging (MRI). The present meta‑analysis aimed to compare dexmedetomidine with propofol in pediatric patients undergoing MRI using trial sequential analysis (TSA). The PubMed, Cochrane Library and Web of Knowledge databases were systematically searched for entries up to August 2018 for potential randomized controlled trials comparing dexmedetomidine with propofol in pediatric patients undergoing MRI. Data were extracted by two independent authors and analyzed using Revman version 5.2 software. Six trials involving 415 pediatric patients were included in the final analysis. A shorter recovery time (P<0.01) and onset time of sedation were identified for propofol compared with dexmedetomidine (P<0.01); however, there were no significant differences in the duration of sedation (P=0.37). Furthermore, pediatric patients receiving propofol were discharged sooner than those receiving dexmedetomidine (P=0.02). The incidence of failed sedation did not significantly differ between the two groups (P=0.81). Propofol induced a lower incidence of 5‑min (P=0.03) and 10‑min Pediatric Anesthesia Emergence Delirium (P<0.01), but a higher incidence of desaturation (P<0.01). The duration of MRI was similar between the two groups (P=0.15). TSA indicated that the monitoring boundary was crossed by the cumulative z curve, providing supportive evidence for the shorter recovery time in the propofol group. Propofol is recommended for pediatric sedation during MRI, owing to shorter recovery time and onset of sedation time, as well as a faster discharge from hospital, and a lower incidence of PAED score >10, compared with dexmedetomidine. However, considering the possibility of desaturation, propofol should be used with caution.

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September 2019
Volume 18 Issue 3

Print ISSN: 1792-0981
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APA
Tang, Y., Meng, J., Zhang, X., Li, J., & Zhou, Q. (2019). Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: A meta‑analysis of randomized controlled trials with trial sequential analysis. Experimental and Therapeutic Medicine, 18, 1775-1785. https://doi.org/10.3892/etm.2019.7751
MLA
Tang, Y., Meng, J., Zhang, X., Li, J., Zhou, Q."Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: A meta‑analysis of randomized controlled trials with trial sequential analysis". Experimental and Therapeutic Medicine 18.3 (2019): 1775-1785.
Chicago
Tang, Y., Meng, J., Zhang, X., Li, J., Zhou, Q."Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: A meta‑analysis of randomized controlled trials with trial sequential analysis". Experimental and Therapeutic Medicine 18, no. 3 (2019): 1775-1785. https://doi.org/10.3892/etm.2019.7751