PMID- 36188426
OWN - NLM
STAT- MEDLINE
DCOM- 20221004
LR  - 20231009
IS  - 1875-8630 (Electronic)
IS  - 0278-0240 (Print)
IS  - 0278-0240 (Linking)
VI  - 2022
DP  - 2022
TI  - The Choice of Anesthetic Drugs in Outpatient Hysteroscopic Surgery: A Systematic 
      Review and Network Meta-Analysis.
PG  - 2408685
LID - 10.1155/2022/2408685 [doi]
LID - 2408685
AB  - OBJECTIVE: Hysteroscopy is a minimally invasive gynecologic technique that is 
      widely practiced in outpatient procedures. The choice of anesthesia is a key 
      factor for the surgical outcome and postoperative recovery. This study was 
      conducted to assess the effects of different anesthetic modalities based on 
      dexmedetomidine in outpatient hysteroscopic surgery anesthesia. METHODS: We did a 
      systematic review and network meta-analysis of outpatient hysteroscopic surgery 
      anesthesia. We searched Pubmed, Embase, and Cochrane-Library from database 
      inception to December 31, 2021. Duplicate literature was excluded and screened 
      separately for initial screening at three tiers: article title, abstract, and 
      full text before deciding whether to include in this study against the above 
      criteria. Results after analysis of categorical variables were expressed as ORR 
      Ratio (95% CI) and continuous variables were expressed as Mean Difference (95% 
      CI). Data collation and analyses were performed using the gemtc package in the R 
      language. RESULTS: Four trials were finally included with data for 301 
      participants, three anesthetic drugs, and five anesthetic modalities. A 
      fixed-effects model was used for the different anesthesia modalities without 
      significant heterogeneity (all I2<20%) in the analysis of adverse events (AEs), 
      the incidence of respiratory depression, operative time, and time in the 
      post-anesthesia care unit (PACU). Remimazolam tosylate was associated with a 
      lower incidence of AEs versus dexmedetomidine, and significant differences 
      between dexmedetomidine and propofol were absent. Propofol and various doses of 
      remimazolam tosylate resulted in a lower incidence of respiratory depression 
      versus dexmedetomidine, with an absence of differences between propofol and 
      dexmedetomidine. The operative time for different anesthetic modalities was, in 
      descending order, dexmedetomidine < remimazolam tosylate 
      (0.60 mg/kg/h <0.48 mg/kg/h) < propofol < remimazolam tosylate (1.00 mg/kg/h), 
      despite the absence of intergroup differences. Propofol was associated with a 
      longer time in PACU versus dexmedetomidine and remimazolam tosylate 
      (1.00 mg/kg/h); those of dexmedetomidine and remimazolam tosylate (1.00 mg/kg/h) 
      were similar. The time in PACU for different anesthetic modalities, in descending 
      order, was dexmedetomidine < remimazolam tosylate (1.00 mg/kg/h) < propofol. 
      Propofol was associated with a longer time in PACU versus dexmedetomidine and 
      remimazolam tosylate. CONCLUSION: In outpatient hysteroscopic surgery anesthesia, 
      dexmedetomidine was associated with a higher incidence of AEs and respiratory 
      depression and a shorter operative time and time in PACU versus remimazolam 
      tosylate and propofol. Remimazolam tosylate showed safety benefits with a similar 
      duration of PACU stay versus dexmedetomidine. Therefore, the choice of anesthetic 
      drugs in outpatient surgery requires consideration of the patient's conditions 
      and preferences.
CI  - Copyright (c) 2022 Shengnan Li et al.
FAU - Li, Shengnan
AU  - Li S
AD  - Outpatient Department, Third Medical Center of Chinese PLA General Hospital, 69 
      Yongding Road, Haidian District, Beijing 100039, China.
FAU - Wu, Bin
AU  - Wu B
AD  - Department of Anesthesiology, Third Medical Center of Chinese PLA General 
      Hospital, 69 Yongding Road, Haidian District, Beijing 100039, China.
FAU - Peng, Bibo
AU  - Peng B
AD  - Outpatient Department, Third Medical Center of Chinese PLA General Hospital, 69 
      Yongding Road, Haidian District, Beijing 100039, China.
FAU - Zhang, Qian
AU  - Zhang Q
AD  - Department of Anesthesiology, Third Medical Center of Chinese PLA General 
      Hospital, 69 Yongding Road, Haidian District, Beijing 100039, China.
FAU - Zhao, Hongdan
AU  - Zhao H
AD  - Outpatient Department, Third Medical Center of Chinese PLA General Hospital, 69 
      Yongding Road, Haidian District, Beijing 100039, China.
FAU - Hou, Kun
AU  - Hou K
AD  - Department of Anesthesiology, Third Medical Center of Chinese PLA General 
      Hospital, 69 Yongding Road, Haidian District, Beijing 100039, China.
FAU - An, Lina
AU  - An L
AUID- ORCID: 0000-0002-7027-9428
AD  - Department of Anesthesiology, Third Medical Center of Chinese PLA General 
      Hospital, 69 Yongding Road, Haidian District, Beijing 100039, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Retracted Publication
PT  - Systematic Review
DEP - 20220921
PL  - United States
TA  - Dis Markers
JT  - Disease markers
JID - 8604127
RN  - 0 (Anesthetics)
RN  - 67VB76HONO (Dexmedetomidine)
RN  - YI7VU623SF (Propofol)
SB  - IM
RIN - Dis Markers. 2023 Sep 27;2023:9760539. PMID: 37810196
MH  - Ambulatory Surgical Procedures/adverse effects
MH  - *Anesthetics/adverse effects
MH  - *Dexmedetomidine/adverse effects
MH  - Female
MH  - Humans
MH  - Hysteroscopy/adverse effects
MH  - Network Meta-Analysis
MH  - Outpatients
MH  - Pregnancy
MH  - *Propofol/adverse effects
MH  - *Respiratory Insufficiency/chemically induced
PMC - PMC9519305
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2022/10/04 06:00
MHDA- 2022/10/05 06:00
PMCR- 2022/09/21
CRDT- 2022/10/03 05:07
PHST- 2022/08/01 00:00 [received]
PHST- 2022/09/09 00:00 [accepted]
PHST- 2022/10/03 05:07 [entrez]
PHST- 2022/10/04 06:00 [pubmed]
PHST- 2022/10/05 06:00 [medline]
PHST- 2022/09/21 00:00 [pmc-release]
AID - 10.1155/2022/2408685 [doi]
PST - epublish
SO  - Dis Markers. 2022 Sep 21;2022:2408685. doi: 10.1155/2022/2408685. eCollection 
      2022.