Evidence map›Paper›PMID 41286611›Full record

SynthesisBMC anesthesiology2025

Effect of dexmedetomidine on postoperative mortality and prognosis: a systematic review and meta-analysis of randomized controlled trials.

Ziwei Xu, Di Wang, Huanan Sun, Wenhui Zhang, Siru Li, Naying Su, Yutao Chen, Chenxin Jiang, Congjie Bi

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ziwei Xu *Department of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Di Wang *Department of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Huanan SunDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Wenhui ZhangDepartment of Anesthesiology, Zhoukou Central Hospital, Zhoukou, Henan, China.
Siru LiDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Naying SuDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Yutao ChenDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Chenxin JiangDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China.
Congjie BiDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, Dalian, Liaoning, China. bcj0411@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis meta-analysis aimed to systematically evaluate the impact of intraoperative dexmedetomidine (DEX) on postoperative mortality and clinical outcomes in surgical patients, addressing existing controversies in the literature.

methodsWe conducted a systematic review of randomized controlled trials (RCTs) from PubMed, Embase and Cochrane Library (inception to October 8, 2024; PROSPERO: CRD42024583524). Included studies compared intraoperative DEX against controls (placebo/active comparators) in adults undergoing general anesthesia. Primary outcome was mortality; secondary outcomes included postoperative delirium (POD), ICU/hospital stay, mechanical ventilation duration, and safety endpoints. Risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI) were pooled using fixed/random-effects models.

resultsThis meta-analysis included 17 randomized controlled trials (RCTs). In cardiac surgery patients, DEX significantly reduced all-cause mortality (RR 0.39, 95% CI 0.18-0.85; P = 0.02) and in-hospital mortality (RR 0.23, 95% CI 0.08-0.70; P = 0.01), but not 30-day mortality. In non-cardiac surgery patients, DEX did not significantly reduce all-cause, 30-day, or in-hospital mortality. DEX decreased the incidence of POD in both cardiac (RR 0.61, 95% CI 0.46-0.82; P = 0.001) and non-cardiac surgery patients (RR 0.56, 95% CI 0.36-0.87; P = 0.01). For other outcomes, significant reductions in hospital stay, ICU stay, and mechanical ventilation duration were primarily observed in the cardiac surgery subgroup. Safety analysis indicated there was no significant difference in intraoperative bradycardia or hypotension between groups.

conclusionsDexmedetomidine use in cardiac surgery significantly reduces all-cause and in-hospital mortality, shortens hospital length of stay, decreases ICU stay duration, and reduces mechanical ventilation requirements. However, its impact on 30-day mortality is not significant. Additionally, the drug consistently demonstrates a preventive effect on postoperative delirium across different surgical types.Clinicians must carefully weigh the benefits of this medication against the potential risk of transient hemodynamic instability.

Indexed as

DexmedetomidineHypnotics and SedativesPostoperative ComplicationsHospital MortalityHumansLength of StayPrognosisRandomized Controlled Trials as TopicDexmedetomidineHypnotics and Sedatives

Identifiers

PMID41286611
PMCPMC12764088

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.