{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:46:32Z","timestamp":1775245592032,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Dexmedetomidine reduces the occurrence of postoperative nausea and vomiting (PONV); however, the effect of dexmedetomidine on PONV in patients undergoing thoracic surgery remains inconclusive. In addition, the effect of different dexmedetomidine application methods, anesthetics, and surgical procedures on the effects of dexmedetomidine on PONV remains unclear. Therefore, the purpose of this meta-analysis was to study the effect of dexmedetomidine on PONV in patients undergoing thoracic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched to identify randomized controlled trials studying the effects of dexmedetomidine on nausea and vomiting after thoracic surgery. In total, 12 articles that met the inclusion criteria were obtained. The primary outcome of this comprehensive analysis was the incidence of PONV; secondary outcomes included the incidence of postoperative nausea, the incidence of postoperative vomiting, postoperative visual analog score (VAS), the amount of intraoperative sufentanil, and the number of times postoperative salvage analgesia was administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve trials involving 905 participants undergoing thoracic surgery were included. Compared with placebo, dexmedetomidine reduced the incidence of nausea and vomiting after thoracic surgery [12 trials; 905 participants; risk ratio (RR) = 0.32; 95% CI (0.23, 0.44); <jats:italic>P<\/jats:italic> &amp;lt; 0.00001, I<jats:sup>2<\/jats:sup> = 0%]. The subgroup analysis revealed that dexmedetomidine reduces the occurrence of PONV in both thoracotomy and thoracoscopic surgery. In addition, both intravenous and local infusion of dexmedetomidine can reduce the occurrence of PONV, and intravenous or inhaled anesthetics do not affect the effect of dexmedetomidine on reducing PONV. Dexmedetomidine can reduce the postoperative resting VAS of patients, and no statistically significant differences in the amount of intraoperative sufentanil and the number of salvage analgesia procedures after surgery were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with placebo, dexmedetomidine can reduce the occurrence of PONV in patients undergoing thoracic surgery, and this effect is not affected by the method of dexmedetomidine administration, use of minimally invasive surgery, and use of a combination of intravenous or inhalation anesthetics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/#myprospero<\/jats:ext-link>, PROSPERO, identifier: CRD42021269358.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.863249","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T06:18:35Z","timestamp":1648707515000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["The Effect of Dexmedetomidine on Postoperative Nausea and Vomiting in Patients Undergoing Thoracic Surgery-A Meta-Analysis of a Randomized Controlled Trial"],"prefix":"10.3389","volume":"9","author":[{"given":"Wei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruohan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinmin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingli","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1136\/thx.2009.123083","article-title":"Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?","volume":"65","author":"Agostini","year":"2010","journal-title":"Thorax."},{"key":"B2","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/00000542-199909000-00022","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers","volume":"91","author":"Apfel","year":"1999","journal-title":"Anesthesiology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1046\/j.1365-2044.2002.02822.x","article-title":"Impact of a multimodal anti-emetic prophylaxis on patient satisfaction in high-risk patients for postoperative nausea and vomiting","volume":"57","author":"Eberhart","year":"2002","journal-title":"Anaesthesia."},{"key":"B4","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1093\/oxfordjournals.bja.a013383","article-title":"Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients","volume":"84","author":"Myles","year":"2000","journal-title":"Br J Anaesth."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1016\/j.suc.2005.09.005","article-title":"Postoperative nausea and vomiting","volume":"85","author":"Williams","year":"2005","journal-title":"Surg Clin North Am."},{"key":"B6","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1213\/ANE.0000000000005245","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan","year":"2020","journal-title":"Anesth Analg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/S1701-2163(16)32895-X","article-title":"Society of obstetricians and gynecologists of Canada. Guideline for the management of postoperative nausea and vomiting","author":"McCracken","year":"2008","journal-title":"J Obstet Gynaecol Can"},{"key":"B8","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1111\/j.1651-2227.2008.00804.x","article-title":"Prevention of post-operative nausea and vomiting in children\u2013a prospective randomized double-blind study","volume":"97","author":"Sakellaris","year":"2008","journal-title":"Acta Paediatr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","article-title":"The effects of increasing plasma concentrations of dexmedetomidine in humans","volume":"93","author":"Ebert","year":"2000","journal-title":"Anesthesiology."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.2147\/DDDT.S251525","article-title":"Comparison of dexmedetomidine and midazolam for the prevention of postoperative nausea and vomiting caused by hemabate in cesarean delivery: a randomized controlled trial","volume":"14","author":"Hu","year":"2020","journal-title":"Drug Des Devel Ther."},{"key":"B11","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/s12630-017-0917-x","article-title":"The effects of intranasal dexmedetomidine premedication in children: a systematic review and meta-analysis","volume":"64","author":"Jun","year":"2017","journal-title":"Can J Anaesth"},{"key":"B12","doi-asserted-by":"publisher","first-page":"352","DOI":"10.3390\/jcm8030352","article-title":"Thoracic paravertebral block with adjuvant dexmedetomidine in video-assisted thoracoscopic surgery: a randomized, double-blind study","volume":"8","author":"Hong","year":"2019","journal-title":"J Clin Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.4037\/ajcc2013610","article-title":"Effects of single-dose dexmedetomidine on the quality of recovery after modified radical mastectomy: a randomised controlled trial","volume":"79","author":"Kim","year":"2013","journal-title":"Minerva Anestesiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1016\/j.revmed.2009.09.015","article-title":"Balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery","volume":"30","author":"Massad","year":"2009","journal-title":"Saudi Med J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1097\/ALN.0b013e31825681cb","article-title":"Effect of perioperative systemic \u03b12 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials","volume":"116","author":"Blaudszun","year":"2012","journal-title":"Anesthesiology."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1016\/j.pain.2013.03.029","article-title":"Is intraoperative dexmedetomidine a new option for postoperative pain treatment? A meta-analysis of randomized controlled trial","volume":"154","author":"Schnabel","year":"2013","journal-title":"Pain."},{"key":"B17","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1097\/00000542-199207000-00023","article-title":"Postoperative nausea and vomiting. Its etiology, treatment, and prevention","volume":"77","author":"Watcha","year":"1992","journal-title":"Anesthesiology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"213","DOI":"10.2165\/00003495-200059020-00005","article-title":"Prevention and treatment of postoperative nausea and vomiting","volume":"59","author":"Kovac","year":"2000","journal-title":"Drugs."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1053\/j.jvca.2016.03.127","article-title":"Effect of oxycodone combined with dexmedetomidine for intravenous patient-controlled analgesia after video-assisted thoracoscopic lobectomy","volume":"30","author":"Wang","year":"2016","journal-title":"J Cardiothorac Vasc Anesth."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e3814","DOI":"10.1097\/MD.0000000000003814","article-title":"Effects of Intraoperative dexmedetomidine on postoperative pain in highly nicotine-dependent patients after thoracic surgery: a prospective, randomized, controlled trial","volume":"95","author":"Cai","year":"2016","journal-title":"Medicine"},{"key":"B21","doi-asserted-by":"publisher","first-page":"ED000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the cochrane handbook for systematic reviews of interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev."},{"key":"B22","doi-asserted-by":"publisher","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ."},{"key":"B23","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"Cochrane bias methods group. Cochrane statistical methods group the cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ."},{"key":"B24","doi-asserted-by":"publisher","first-page":"962280219889080","DOI":"10.1177\/0962280219889080","article-title":"DEPRESsion Screening Data (DEPRESSD) Collaboration. Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis","volume":"30","author":"McGrath","year":"2020","journal-title":"Stat Methods Med Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.21037\/jtd.2018.02.10","article-title":"Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period","volume":"10","author":"Hwang","year":"2018","journal-title":"J Thorac Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"668","DOI":"10.21037\/atm.2019.10.74","article-title":"Comparison of dexmedetomidine and dexamethasone as adjuvant for ropivacaine in ultrasound-guided erector spinae plane block for video-assisted thoracoscopic lobectomy surgery: a randomized, double-blind, placebo-controlled trial","volume":"7","author":"Gao","year":"2019","journal-title":"Ann Transl Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s13019-021-01472-4","article-title":"Dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia increases female patients' global satisfaction degree after thoracoscopic surgery","volume":"16","author":"Li","year":"2021","journal-title":"J Cardiothorac Surg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2673","DOI":"10.2147\/JPR.S208014","article-title":"Comparison of dexmedetomidine or sufentanil combined with ropivacaine for epidural analgesia after thoracotomy: a randomized controlled study","volume":"12","author":"Yan","year":"2019","journal-title":"J Pain Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12871-017-0324-4","article-title":"Effect of dexmedetomidine combined with sufentanil for post- thoracotomy intravenous analgesia:a randomized, controlled clinical study","volume":"17","author":"Dong","year":"2017","journal-title":"BMC Anesthesiol."},{"key":"B30","first-page":"E185","article-title":"Whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia for patients with lung cancer undergoing thoracoscopic surgery: a randomized control trial","volume":"23","author":"Miao","year":"2020","journal-title":"Pain Physician."},{"key":"B31","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1053\/j.jvca.2017.06.023","article-title":"Multilevel thoracic paravertebral block using ropivacaine with\/without dexmedetomidine in video-assisted thoracoscopic surgery","volume":"32","author":"Xu","year":"2018","journal-title":"J Cardiothorac Vasc Anesth."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e2854","DOI":"10.1097\/MD.0000000000002854","article-title":"Intraoperative dexmedetomidine improves the quality of recovery and postoperative pulmonary function in patients undergoing video-assisted thoracoscopic surgery: a CONSORT-prospective, randomized, controlled trial","volume":"95","author":"Lee","year":"2016","journal-title":"Medicine."},{"key":"B33","doi-asserted-by":"publisher","first-page":"826","DOI":"10.4103\/ija.IJA_221_17","article-title":"Evaluation of the role of dexmedetomidine in improvement of the analgesic profile of thoracic paravertebral block in thoracic surgeries: a randomised prospective clinical trial","volume":"61","author":"Hassan","year":"2017","journal-title":"Indian J Anaesth."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e95287","DOI":"10.5812\/aapm.95287","article-title":"Effect of dexmedetomidine combined with inhalation of isoflurane on oxygenation following one-lung ventilation in thoracic surgery","volume":"10","author":"Asri","year":"2020","journal-title":"Anesth Pain Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1093\/ejcts\/ezs428","article-title":"Outcomes after lobectomy using thoracoscopy vs thoracotomy: a comparative effectiveness analysis utilizing the Nationwide Inpatient Sample database","volume":"43","author":"Paul","year":"2013","journal-title":"Eur J Cardiothorac Surg."},{"key":"B36","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12871-018-0632-3","article-title":"Propofol vs inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis","volume":"18","author":"Schraag","year":"2018","journal-title":"BMC Anesthesiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"441","DOI":"10.4103\/aer.AER_105_19","article-title":"Comparing efficacy of perineural dexmedetomidine with intravenous dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block","volume":"13","author":"Somsunder","year":"2019","journal-title":"Anesth Essays Res."},{"key":"B38","doi-asserted-by":"publisher","first-page":"i27","DOI":"10.1093\/bja\/aer358","article-title":"Multimodal therapies for postoperative nausea and vomiting, and pain","volume":"107","author":"Chandrakantan","year":"2011","journal-title":"Br J Anaesth."},{"key":"B39","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1007\/BF03021622","article-title":"Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements","volume":"53","author":"Gurbet","year":"2006","journal-title":"Can J Anaesth."},{"key":"B40","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1213\/01.ane.0000195234.07413.5a","article-title":"Dexmedetomidine-induced decreases in accumbal dopamine in the rat are partly mediated via the locus coeruleus","volume":"102","author":"Whittington","year":"2006","journal-title":"Anesth Analg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.863249\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T06:18:38Z","timestamp":1648707518000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.863249\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,31]]},"references-count":40,"alternative-id":["10.3389\/fsurg.2022.863249"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.863249","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,31]]},"article-number":"863249"}}