Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial
- Wen-Jun Zhou
- Mei Liu
- Xue-Peng Fan
Affiliations: Department of Anesthesiology, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, Hubei 430015, P.R. China, Department of Intensive Care Unit, Wuhan No. 1 Hospital, Wuhan, Hubei 430022, P.R. China
- Published online on: December 17, 2020 https://doi.org/10.3892/etm.2020.9297
Copyright: © Zhou
et al. This is an open access article distributed under the
terms of Creative
Commons Attribution License.
Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
The present study aimed to compare the efficacy and safety of dexmedetomidine and midazolam in patients that are critically ill. Full text articles reporting the clinical effects and complications of dexmedetomidine and midazolam were retrieved from multiple databases. Review Manager 5.0 was adopted for meta‑analysis, sensitivity and bias analysis. Finally, a total of 1,379 patients from 8 studies, which met the eligibility criteria, were included. The meta‑analysis suggested that the length of stay at the intensive care unit [mean absolute difference (MD)=‑1.80; 95% confidence interval (CI), ‑2.13, ‑1.48; P<0.00001; P‑value for heterogeneity=0.41; I²=3%], time to extubation (MD=‑2.18; 95% CI, ‑2.66, ‑1.69; P<0.00001; P‑value for heterogeneity=0.84; I²=0%) and delirium (MD=0.46; 95% CI, 0.37, 0.57; P<0.00001; P‑value for heterogeneity=0.65; I²=0%) was higher following midazolam treatment compared with dexmedetomidine, while bradycardia [odds ratio (OR)=5.03; 95% CI, 3.86, 6.57; P<0.00001; P‑value for heterogeneity=0.13; I²=38%] was higher in dexmedetomidine treated patients compared with midazolam. However, no difference was observed in the incidence of hypotension (OR=0.88; 95% CI, 0.70, 1.10; P=0.26; P‑value for heterogeneity=0.99; I²=0%) and mortality (OR=0.96; 95% CI, 0.74, 1.25; P=0.77; P‑value for heterogeneity=0.99; I²=0%). Taking clinical effects and safety into account, the present study suggested dexmedetomidine to be the preferred option of anesthesia for patients that are critically ill.