Abstract: Objective To assess the advantages and disadvantages of using dexmedetomidine(Dex) or esmolol (Esm) respectively in controlling hypotension during general anesthesia in operation by Meta-analysis. Methods We searched all randomized controlled trial(RCT) relating to controlled hypotension with Dex or Esm during general anesthesia in online database of PubMed, EMBASE, Medline, Cochrane Library, Web of Science, CBM, CKNI, Wangfang Data Resource and VIP. The quality of trials was strictly assessed according to the Cochrane Collaboration manual. RevMan 5.3 software was used for data analysis. Results Ten RCT with 568 cases were included. Meta-analysis showed that there were no significant statistically differences between the two groups on the achievement ratio of controlled hypotension [risk ratio (RR) =1.04, 95%(confidence interva, CI)(1.00, 1.08)], the number of patients with surgical field score≤2 [RR=1.01, 95%CI (0.94, 1.09)] and the surgical field scores [weighted mean difference (WMD) =-0.12, 95%CI (-0.28, 0.03)] (P>0.05). Dex group needed less dose of fentanyl in operation [WMD=-38.85, 95%CI (-49.66, -28.05)], but the time to first analgesic request [WMD=29.89, 95%CI (22.61, 37.17)] and recovery time [WMD=4.11, 95%CI (2.57, 5.66)] in this group were longer. Also there is less incidence of postoperative nausea or vomiting in Dex group [RR=0.41, 95%CI (0.18, 0.93)] (P<0.05). Conclusions Dex and Esm are both safe drugs for controlling hypotension during general anesthesia in operation. Dex may have better effect on reducing general anesthetics in operation, reducing pain of post?蛳operation and decreasing incidence of postoperative nausea or vomiting happened on patients. But it may lead to delay of regaining conscious of patients.
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