Effect of Dexmedetomidine on Motor Evoked Potentials in the Adult Population: Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.5281/zenodo.10607542Abstract
BACKGROUND: Dexmedetomidine (DEX) is commonly used as an adjunct to total intravenous anesthesia (TIVA) to help reduce intraoperative consumption of propofol and opioids. However, the effect of DEX on transcranial motor-evoked potential (TCeMEPs) monitoring has remained controversial due to the covariances of dosage used, the presence of initial bolus, patient population, and duration of anesthesia. This systematic review and meta-analysis aimed to evaluate the effect of DEX on TCeMEPs amplitude in the adult population by analyzing different DEX dosage infusion groups interacting with different covariances.
METHODS: This systematic review consisted of meta-analyses of the literature from PubMed, Google Scholar, Science Direct, Springer, and some other sources to quantify the effect of DEX on TCeMEP amplitude. The total cohort consisted of 402 patients who underwent surgery with intraoperative TCeMEP monitoring and used DEX as an adjunct. For each study selected, various factors were collected, such as the dosage of DEX, the presence of initial bolus, TIVA regime, sample size, TCeMEPs amplitude at baseline and after DEX infusion, and the time when amplitudes were obtained. For the studies that did not report the amplitude of TCeMEPs, the number of times when TCeMEPs were lost during surgery was recorded. After data was extracted from the included studies, the effect size was investigated using a random effects model. Cochran Q test was used to evaluate the heterogeneity of studies and subgroups.
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