Pediatric anesthesia & critical care
Dexmedetomidine in pediatric tonsillectomy: a systematic review with meta-analysis
Pooled result · Perioperative opioid requirementsResult — go to the resultMD −0.25 mg·kg-1 OME 95% CI −0.36 to −0.13Authors' conclusion
Dexmedetomidine may improve the perioperative course of children undergoing tonsillectomy by decreasing perioperative opioid requirements and dose-dependently lowering the incidence of ED.
Study context
- Population
- Patients aged 18 yr or younger undergoing tonsillectomy16 trials
- Comparison
- IV dexmedetomidine + opioids vs opioids
- Outcome
- Perioperative opioid requirements (oral morphine equivalents, OME)
Methodological detailsrandom effects model, meta-regression, Grading of Recommendations Assessment, Development, and Evaluation (GRADE)
- Random effects model
- Meta-regression
- GRADE
Pooled result
Perioperative opioid requirements
MD
−0.25 mg·kg-1 OME
95% CI −0.36 to −0.13
DEX vs Opioids
MD −0.25 mg·kg-1 OME (95% CI −0.36 to −0.13)
As reported in the abstract
- Relative reduction of perioperative oral morphine equivalents (OME)
- 40%
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Emergence delirium (ED)Moderate certainty; 3 trials | 0.24 (0.08–0.71) | |
| PONVI2 = 0%; low certainty; 12 trials | 0.48 (0.35–0.66) | |
| 0.050.21520Relative risk (log scale) |
- Emergence delirium (ED) — RR of ED decrease per 0.5 µg·kg-1 increment in dexmedetomidine (DEX) dose
- 87%
Safety
Perioperative respiratory adverse events (sustained or severe cough)
- DEX did not reduce the incidence of sustained or severe cough
- 4 trials
Original publication
Dexmedetomidine in pediatric tonsillectomy: a systematic review with meta-analysis. Can J Anaesth. Published 11 July 2025. doi:10.
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