Impact of perioperative dexmedetomidine on postoperative delirium in adult undergoing cardiac surgery: A comprehensive bibliometrix and meta-analysis

Abstract

This bibliometrix and meta-analysis aimed to evaluate the efficacy of perioperative dexmedetomidine (DEX) on postoperative delirium (POD) in adult patients undergoing cardiac surgery. A comprehensive search of electronic databases identified 21 randomized controlled trials involving 5210 patients. The primary outcome was the incidence of POD from the first day to seven days post-surgery. The meta-analysis revealed that DEX significantly reduced POD incidence compared to various controls (RR 0.70; 95 % CI 0.54–0.89; P = 0.004). Subgroup analyses showed that DEX was particularly effective when compared to propofol (RR 0.48; 95 % CI 0.30–0.78; P = 0.003). However, no significant differences were observed in the duration of anesthesia, surgery, or ICU/hospital stay. Notably, DEX was associated with a higher incidence of hypotension (RR 1.90; 95 % CI 1.16–3.10; P = 0.01). The study highlights the potential neuroprotective benefits of DEX but underscores the need for careful monitoring of hemodynamic stability. Future research should focus on optimizing DEX dosing protocols and exploring its broader impact on postoperative recovery and patient outcomes.