标题：Safety and sedative effect of intranasal dexmedetomidine in mandibular third molar surgery: a systematic review and meta-analysis
作者：Liu, Shaopeng; Wang, Ye; Zhu, Yong; Yu, Tingting; Zhao, Huaqiang
作者机构：[Liu, Shaopeng; Wang, Ye; Zhu, Yong; Zhao, Huaqiang] Shandong Univ, Sch Stomatol, Shandong Prov Key Lab Oral Tissue Regenerat, Jinan 250012, Shandong, 更多
通讯作者：Zhao, HQ;Yu, TT
通讯作者地址：[Zhao, HQ]Shandong Univ, Sch Stomatol, Dept Oral & Maxillofacial Surg, 44 Wen Hua Xi Lu, Shandong 250012, Shandong, Peoples R China;[Yu, TT]Jinan Stom 更多
来源：DRUG DESIGN DEVELOPMENT AND THERAPY
关键词：intranasal dexmedetomidine; sedation; mandibular third molar;; meta-analysis
摘要：Objective: The focus of this meta-analysis was to assess the sedative effect and safety of intranasal dexmedetomidine (Dex) in mandibular third molar surgery.; Methods: The PubMed/Medline, Web of Science, Cochrane Library, and China National Knowledge Infrastructure databases were searched Ibr studies published until May 1, 2018. Eligible studies were restricted to randomized controlled trials (RCTs) and controlled clinical trials. The evaluation indicators mainly included the bispectral index, observer assessment of alertness/sedation scale, systolic blood pressure, and heart rate. Data for each period in the Dex and control groups were pooled to evaluate its sedative effect and safety.; Results: Five RCTs met the inclusion criteria. This study included 363 patients: 158 patients received intranasal inhalation of Dex before surgery, and 158 patients were negative controls. The pooled results showed a good sedative effect during tooth extraction when intranasal inhalation of Dex was performed 30 minutes before third molar extraction (assessment of alertness/sedation, Dex vs control SMD -1.20, 95% CI -1.73 to -0.67, P=0, P=0.95; bispectral index, Dex vs control SMD -11.68, 95% CI -19.49 to -3.87, I-2=89%; P=0.0001), and parameters returned to normal within 90 minutes after inhalation. During the operation, blood pressure and heart rate decreased to some extent, but the decreases did not exceed 20% of the baseline, and all patients returned to normal conditions within 90 minutes after inhalation.; Conclusion: Intranasal inhalation of Dex 30 minutes before third molar extraction can provide a good sedative effect, and large-sample multicenter RCTs are needed to evaluate the analgesic effect of Dex.