Dexmedetomidine Versus Chloral Hydrate For Sedation Before Pediatric-Assisted Examination:A Meta-analysis

Objective:Now,assisted sedation in pediatric examination remains to be a challenge.This study aims to compare the safety and effectiveness of dexmedetomidine and chloral hydrate to help pediatric patients complete auxiliary examination.Methods:The CNKI,CBM,PubMed,the Cochrane,Embase database were searched for both in English and Chinese published up to February 2020,we included the studys that compared dexmedetomidine and chloral hydrate to help children complete auxiliary examination,the main outcome indicators include The main outcome indicators included the success rate of sedation,the incidence of respiratory depression,the incidence of bradycardia and hypotension,Secondary indicators are the onset time of sedation and the recovery time after sedation,the incidence of vomiting.Relevant data of primary and secondary outcome indicators were collected,and meta-analysis was performed with RevMan5.3 software.Results:A total of 12 randomized controlled clinical studies of dexmedetomidine and chloral hydrate sedation were included in this study.There were 1146 patients in the dexmedetomidine group and 621 in the chloral hydrate group.The Meta-analysis results showed that in terms of sedation success rate,the dexmedetomidine group was higher than the chloral hydrate group,the difference was statistically significant [OR = 2.30,95% CI(1.37,3.86),P = 0.002];in the incidence of respiratory depression,dexmedetomidine has a lower incidence of respiratory adverse reactions,the difference is statistically significant [OR = 0.32,95% CI(0.14,0.75),P = 0.009];in the incidence of bradycardia,dexmedetomidine was higher than chloral hydrate,and the difference was statistically significant [OR = 4.57,95% CI(1.92,10.85),P = 0.0006];the incidence of hypotension was not statistically significant between the two groups [OR = 1.20,95% CI(0.47,3.04),P = 0.71];in the sedation onset time,the onset time was shorter in the dexmedetomidine group,the difference was statistically significant [MD=-1.98,95%CI(-3.96,-0.11),P = 0.04];Dexmedetomidine is also superior to chloral hydrate in the time of recovery from sedation,the difference is statistically significant [MD=-9.31,95% CI(-13.96,-4.66),P <0.0001];in the incidence of vomiting,the incidence of vomiting of chloral hydrate was higher,the difference was statistically significant [OR=0.04,95%CI(0.02,0.11),P <0.00001].Conclusion:1.Dexmedetomidine has a higher sedation success rate and lower incidence of respiratory adverse events than chloral hydrate;2.There is no significant difference in the incidence of hypotension between dexmedetomidine and chloral hydrate;3.Dexmedetomidine has a higher probability of bradycardia rate than chloral hydrate;4.Dexmedetomidine has a lower incidence of vomiting than chloral hydrate;5.Dexmedetomidine has a shorter sedative onset time than chloral hydrate;6.Dexmedetomidine has a shorter recovery time than chloral hydrate after sedation.