Evidence map›Paper›PMID 40830748›Full record

SynthesisBMC anesthesiology2025

Dexmedetomidine for the prevention of postoperative delirium in patients undergoing cardiac surgery: a systematic review and meta-analysis with trial sequential analysis.

Yiyang Zhong, Zhizhen Ren, Jie Gao, Xingjian He, Qian Li

Abstract readSystematic ReviewMeta-Analysis
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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Post-Operative Delirium in Elderly Patients: A Narrative Review.International journal of molecular sciences · 2025
    Review
  4. Molecular and Clinical Considerations for Anesthesia in the Aging Brain.International journal of molecular sciences · 2025
    Review
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

5 authors.

Yiyang ZhongWest China School of Medicine and West China Hospital, Sichuan University, Chengdu, China.ORCID http://orcid.org/0009-0008-2758-353X
Zhizhen RenWest China School of Medicine and West China Hospital, Sichuan University, Chengdu, China.ORCID http://orcid.org/0009-0001-7953-2928
Jie GaoWest China School of Medicine and West China Hospital, Sichuan University, Chengdu, China.ORCID http://orcid.org/0009-0006-6700-7057
Xingjian HeSchool of Medicine, The Chinese University of Hong Kong, Shenzhen, China.ORCID http://orcid.org/0009-0005-8173-4018
Qian LiWest China School of Medicine and West China Hospital, Sichuan University, Chengdu, China. hxliqian@wchscu.cn.ORCID http://orcid.org/0009-0000-4732-6233

Funding

Sichuan Science and Technology Program 2023ZYD0168
6 · The paper itself

Abstract

backgroundThe efficacy of dexmedetomidine in preventing postoperative delirium (POD) following cardiac surgery remains controversial. This systematic review aimed to evaluate whether dexmedetomidine could prevent POD in patients undergoing cardiac surgery.

methodsPubMed, CENTRAL, and Embase were searched up to 1 November 2024. Randomized controlled trials (RCTs) concerning dexmedetomidine for preventing POD in patients undergoing cardiac surgery were included. The primary outcome was the incidence of POD, and the secondary outcome was the incidence of postoperative atrial fibrillation (POAF). The analyses were performed using RevMan 5.3 and R 4.4.2 to calculate risk ratio (RR) with 95% confidence interval (CI). Trial sequential analysis (TSA) was conducted using TSA 0.9.5.10 Beta.

resultsThirty-two studies with 6046 participants were included. Dexmedetomidine notably reduced the incidence of POD (RR = 0.67, 95% CI 0.59-0.76, P < 0.00001), with sufficient evidence and conclusive result from TSA. Dexmedetomidine was more effective in preventing POD compared with both positive control (RR = 0.47, 95% CI 0.38-0.59, P < 0.00001) and placebo control (RR = 0.83, 95% CI 0.70-0.98, P = 0.02). It reduced the incidence of POD not only in elderly patients (RR = 0.66, 95% CI 0.54-0.81, P < 0.0001) but also in normal age patients (RR = 0.68, 95% CI 0.57-0.80, P < 0.00001). Moreover, dexmedetomidine decreased the incidence of POAF (RR = 0.82, 95% CI 0.74-0.92, P = 0.0005).

conclusionsDexmedetomidine could reduce the incidence of POD in patients undergoing cardiac surgery and was associated with a decreased incidence of POAF. The findings should be interpreted with caution because of the low to moderate quality of evidence. Further trials are still needed to explore the optimal regimen of dexmedetomidine. REGISTRATION NUMBER: INPLASY2024110008.

Indexed as

Cardiac Surgical ProceduresDeliriumDexmedetomidineEmergence DeliriumHypnotics and SedativesPostoperative ComplicationsAtrial FibrillationHumansRandomized Controlled Trials as TopicDexmedetomidineHypnotics and SedativesDexmedetomidineMeta-analysisPostoperative deliriumTrial sequential analysis

Identifiers

PMID40830748
PMCPMC12366164

What Socratic holds

Textmetadata
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 Socratic graph.