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Efficacy and safety of intranasal dexmedetomidine versus oral chloral hydrate as sedatives for pediatric patients: a systematic review and meta-analysis
  1. Jun Wang1,
  2. Yong Li2,
  3. Shuna Xiao3,
  4. Buyun Shi2,
  5. Zhi Xia2,
  6. Chengjiao Huang2,
  7. Hui Xu2,
  8. Na Li1,
  9. Wen Tang2
  1. 1Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
  2. 2Department of Pediatric Intensive Care Unit, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
  3. 3Liyuan Cardiovascular Center, Tongji Medical College,Huazhong University of Science and Technology, Wuhan, Hubei, China
  1. Correspondence to Dr Wen Tang, Department of Pediatric Intensive Care Unit, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei 430070, China; 490760371{at}qq.com; Dr Hui Xu; 382786045{at}qq.com

Abstract

This study was designed to review published literature to determine the efficacy and safety of intranasal dexmedetomidine versus oral chloral hydrate (CH) for sedation in pediatric patients based on qualified studies. We searched the PubMed, Cochrane, and Embase databases for qualified studies published before March 2021. For each study, we analyzed the relative risk or weighted mean difference combined with a 95% CI. Fourteen studies including 3749 pediatric patients were included in this meta-analysis. Compared with oral CH, intranasal dexmedetomidine significantly increased the success rate of sedation and decreased the duration and latency of sedation, time of recovery from sedation, and total sedation time. Compared with oral CH, intranasal dexmedetomidine significantly decreased the incidence of adverse events, including vomiting, but increased the incidence of bradycardia. In conclusion, intranasal dexmedetomidine provides better sedation than oral CH for pediatric patients with good safety; however, the incidence of bradycardia is increased.

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Footnotes

  • JW and YL contributed equally.

  • Contributors All authors have made substantial contributions to conception and design of the study, searching literature, extracting data and analyzing data. JW and YL wrote the manuscript. WT revised the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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