• Wei-Guo Zhong, Xin-Yu Ge, Hai Zhu, Xiao Liang, Hong-Xia Gong, Ming Zhong, and Xiang Xiao.
• Department of Obstetrics, Shanghai Changning District Maternity and Infant Health Hospital Changning District, Shanghai 200051, P. R. China.
• Int J Clin Exp Med. 2015 Jan 1;8(9):14566-76.

PurposePostoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries.MethodsThree main electronic databases including Pub Med, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) were searched by two researchers independently. The metaanalysis was completed using Review Manager.ResultsEleven RCTs with 692 patients were included in this metaanalysis. Dexmedetomidine a bridged postoperative nausea [Risk Ratio (RR)=0.59, 95% confidence interval (CI): 0.44 to 0.79] and vomiting [RR=0.48, 95% CI: 0.36 to 0.64] compared with placebo. Despite of higher incidence of intra operative bradycardia [RR 2.87, 95% CI 1.08 to 7.58] and hypotension [RR 4.26, 95% CI 1.43 to 12.69], we found significant decrease in postoperative shivering [RR 0.23, 95% CI 0.13 to 0.40] and pruritus [RR 0.40, 95% CI 0.17 to 0.93] in dexmedetomidine group, as well as the pain scores [standard mean difference (SMD)-0.96, 95% CI-1.37 to-0.54]. Significant reductions in the need for intraoperative fentanyl (RR 0.10, 95% CI 0.01-0.76, I(2) 0%), antiemetic (RR 0.62, 95% CI 0.39-0.99, I(2) 0%) and postoperative analgesic (RR 0.18, 95% CI 0.08-0.42, I(2) 0%) were also elicited.ConclusionsThe current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.

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