Dexmedetomidine Addition For Pediatric Hernia Repair: A Meta-Analysis of Randomized Controlled Studies

Introduction: The efficacy of dexmedetomidine addition for pain control after pediatric hernia repair remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexmedetomidine addition on pain management for pediatric hernia repair. Methods: : We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine addition on pain management for pediatric hernia repair. This meta-analysis is performed using the random-effect model. Results: : Six RCTs are included in the meta-analysis. Overall, compared with control group for pediatric hernia repair, dexmedetomidine addition is associated with significantly reduced analgesic consumption (SMD=-1.0; 95% CI=-1.40 to -0.61; P<0.00001) and number of rescue analgesics (SMD=0.16; 95% CI=0.06 to 0.41; P=0.0002), prolonged time to first analgesia (SMD=8.16; 95% CI=4.58 to 11.73; P<0.00001) and decreased the incidence of emergence agitation (RR=0.12; 95% CI=0.03 to 0.44; P=0.001), but has no obvious impact on pain scores at 1 h (SMD=-2.00; 95% CI=-5.78 to 1.79; P=0.30) or 2 h (SMD=-0.73; 95% CI=-2.33 to 0.87; P=0.37). Conclusions: : Dexmedetomidine addition is beneficial to pain control after pediatric hernia repair.