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Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial

  • Authors:
    • Wen-Jun Zhou
    • Mei Liu
    • Xue-Peng Fan
  • View Affiliations / Copyright

    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
    Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 156
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    Published online on: December 17, 2020
       https://doi.org/10.3892/etm.2020.9297
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Abstract

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.
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Copy and paste a formatted citation
Spandidos Publications style
Zhou W, Liu M and Fan X: Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial. Exp Ther Med 21: 156, 2021.
APA
Zhou, W., Liu, M., & Fan, X. (2021). Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial. Experimental and Therapeutic Medicine, 21, 156. https://doi.org/10.3892/etm.2020.9297
MLA
Zhou, W., Liu, M., Fan, X."Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial". Experimental and Therapeutic Medicine 21.2 (2021): 156.
Chicago
Zhou, W., Liu, M., Fan, X."Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial". Experimental and Therapeutic Medicine 21, no. 2 (2021): 156. https://doi.org/10.3892/etm.2020.9297
Copy and paste a formatted citation
x
Spandidos Publications style
Zhou W, Liu M and Fan X: Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial. Exp Ther Med 21: 156, 2021.
APA
Zhou, W., Liu, M., & Fan, X. (2021). Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial. Experimental and Therapeutic Medicine, 21, 156. https://doi.org/10.3892/etm.2020.9297
MLA
Zhou, W., Liu, M., Fan, X."Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial". Experimental and Therapeutic Medicine 21.2 (2021): 156.
Chicago
Zhou, W., Liu, M., Fan, X."Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta‑analysis of randomized controlled trial". Experimental and Therapeutic Medicine 21, no. 2 (2021): 156. https://doi.org/10.3892/etm.2020.9297
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