SynthesisNeurocritical care2026
Efficacy of Dexmedetomidine in Preventing Postoperative Delirium in Patients Undergoing Brain Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDexmedetomidine (DEX), a selective alpha-2 adrenergic receptor agonist, is widely used in various surgical settings, including cardiac and general surgeries, for its sedative, analgesic, and neuroprotective properties. Patients undergoing brain surgery are particularly susceptible to postoperative delirium (POD). Given the established benefits of dexmedetomidine in other surgical fields, its potential to mitigate delirium in neurosurgery warrants investigation.
methodsA systematic search of PubMed, Embase, Scopus, and Cochrane databases was conducted from inception to January 2025 and updated in April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed, and a meta-analysis was performed using Review Manager 5.4.1. Five randomized controlled trials were included, evaluating the efficacy of DEX in preventing POD in adult patients undergoing brain surgery.
resultsA total of 646 patients were enrolled, with DEX administered with a loading dose ranging from 0.5 to 1 μg/kg over 10 min, followed by a maintenance infusion rate of 0.1 to 0.5 μg/kg/h during the surgical procedure. The pooled risk ratio (RR) for POD with DEX was 0.47 (95% confidence interval (CI): 0.35-0.63; p < 0.00001); reflecting a 53% reduction in the risk of postoperative delirium, with no statistical heterogeneity detected (χ
conclusionsThis meta-analysis found that perioperative dexmedetomidine was associated with a significant reduction in postoperative delirium risk in neurosurgical patients. Further multicenter trials are needed to confirm these findings and to refine optimal administration strategies.
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