Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised.

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Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials X. Duan, M. Coburn, R. Rossaint, R.D. Sanders, J.V. Waesberghe, A. Kowark British Journal of Anaesthesia Volume 121, Issue 2, Pages 384-397 (August 2018) DOI: 10.1016/j.bja.2018.04.046 Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

Fig 1 Postoperative delirium incidence within cardiac or non-cardiac surgery. (a) Forest plot with subgroup analysis ‘cardiac surgery’ and ‘non-cardiac surgery’. (b) Trial sequential analyses for ‘cardiac surgery’ subgroups: error α=5%, β=20%, incidence in intervention arm (IIA)=8.09%, incidence in control arm (ICA)=15.37%. (c) Trial sequential analyses for ‘non-cardiac surgery’ subgroups: error α=5%, β=20%, IIA=11.55%, ICA=21.44%. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

Fig 2 Postoperative delirium incidence depending on the different intervention time-point. (a) Forest plot with subgroups of different intervention time-points. (b) Trial sequential analyses (TSA) for ‘intraoperative period’ subgroup: error α=5%, β=20%, IIA=10.76%, ICA=25.0%. (c) TSA for ‘postoperative period’ subgroup: error α=5%, β=20%, IIA=9.34%, ICA=21.23%. (d) TSA for ‘perioperative period (during surgery and continued on ICU)’ subgroup: error α=5%, β=20%, IIA=11.62%, ICA=20.57%. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

Fig 3 Postoperative delirium incidence within different age subgroups. (a) Forest plot with different age subgroups. (b) Trial sequential analyses for the subgroup analysis of patients aged <65 yr: error α=5%, β=20%, IIA=1.56%, ICA=6.25%. (c) Trial sequential analyses for the subgroup analysis of ≥65 yr old patients: error α=5%, β=20%, IIA=11.30%, ICA=20.52%. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

figs1PRISMA-flow diagram for the literature search and exclusion criteria. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

figs2Funnel plot for the total postoperative delirium incidence did not suggest the presence of publication bias. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions

figs3Funnel plot for the postoperative delirium incidence, when dexmedetomidine was administered during the postoperative period (after surgery), did not suggest the presence of publication bias. British Journal of Anaesthesia 2018 121, 384-397DOI: (10.1016/j.bja.2018.04.046) Copyright © 2018 British Journal of Anaesthesia Terms and Conditions