Cataract surgery is one of the most common procedures performed worldwide in the elderly. Various medications can provide effective anesthesia and analgesia for cataract surgery, but undesirable side effects limit the utility of each medication or combination of medications. Dexmedetomidine may serve as an anesthesia adjunct for outpatient cataract surgery in the elderly. Searches were conducted in Cochrane, Embase, and PubMed for randomized clinical trials investigating the use of dexmedetomidine in adult patients undergoing outpatient, or ambulatory, cataract surgery with sedation and topical or peribulbar block. Ninety-nine publications were identified, of which 15 trials satisfied the inclusion criteria. A total of 914 patients were included in this review. The following data were collected: American Society of Anesthesiologists’ (ASA) physical status and age of study patients; method of blinding and randomization; medication doses and routes of administration; and intraoperative levels of sedation. We also recorded statistically significant differences between dexmedetomidine and other study medications or placebo with respect to the following outcomes: hemodynamic and respiratory parameters; pain; sedation; post-operative nausea and vomiting (PONV); discharge from post-anesthesia care unit (PACU) or recovery times; patient satisfaction; surgeon satisfaction; and effects on intraocular pressure (IOP). Hypotension with or without bradycardia was reported following bolus doses of dexmedetomidine ranging from 0.5–1.0 mcg/kg with or without a continuous dexmedetomidine infusion. Delayed PACU discharge times were associated with the use of dexmedetomidine, but no clear association was identified between delayed recovery and higher levels of intraoperative sedation. Better analgesia and higher patient satisfaction were commonly reported with dexmedetomidine as well as reductions in IOP. Overall, this review demonstrates better analgesia, higher patient satisfaction, and reduced IOP with dexmedetomidine for outpatient cataract surgery when compared to traditional sedatives, hypnotics, and opioids. These benefits of dexmedetomidine, however, must be weighed against relative cardiovascular depression and delayed PACU discharge or recovery times. Therefore, the utility of dexmedetomidine for outpatient cataract surgery should be considered on a patient-by-patient basis.

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围手术期右美托咪定用于门诊白内障手术的系统评价。

白内障手术是全世界老年人最普遍的手术之一。各种药物可以为白内障手术提供有效的麻醉和镇痛作用，但是不良的副作用限制了每种药物或药物组合的效用。右美托咪定可作为老年人门诊白内障手术的麻醉辅助手段。在Cochrane，Embase和PubMed中进行了随机临床试验，以调查右美托咪定在接受门诊或非卧床，白内障手术，镇静和局部或球周封闭的成年患者中的使用。确定了99个出版物，其中15个试验符合纳入标准。该评价共纳入914例患者。收集了以下数据：美国麻醉医师学会（ASA）的身体状况和研究患者的年龄；盲法和随机化方法；药物剂量和给药途径；和术中镇静水平。我们还记录了右美托咪定与其他研究药物或安慰剂在以下方面的统计学差异：血流动力学和呼吸参数；疼痛; 镇静剂 术后恶心呕吐（PONV）；从麻醉后护理单位（PACU）出院或恢复时间；患者满意度；外科医生满意度 及其对眼内压（IOP）的影响。据报道，右美托咪定的单次剂量为0.5-1.0 mcg / kg时，伴或不伴心动过缓的低血压患者，可连续或不连续注射右美托咪定。延迟的PACU排出时间与右美托咪定的使用有关，但是在恢复的延迟与术中较高的镇静水平之间没有明确的关联。右美托咪定通常报告有更好的镇痛作用和更高的患者满意度，以及IOP降低。总的来说，与传统的镇静剂，催眠药和阿片类药物相比，右美托咪定对门诊白内障手术的镇痛效果更好，患者满意度更高，眼压降低。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。但恢复延迟与术中较高镇静水平之间没有明确的关联。右美托咪定通常报告有更好的镇痛作用和更高的患者满意度，以及IOP降低。总的来说，与传统的镇静剂，催眠药和阿片类药物相比，右美托咪定对门诊白内障手术的镇痛效果更好，患者满意度更高，眼压降低。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。但恢复延迟与术中较高镇静水平之间没有明确的关联。右美托咪定通常报告有更好的镇痛作用和更高的患者满意度，以及IOP降低。总的来说，与传统的镇静剂，催眠药和阿片类药物相比，右美托咪定对门诊白内障手术的镇痛效果更好，患者满意度更高，眼压降低。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。右美托咪定通常报告有更好的镇痛作用和更高的患者满意度，以及IOP降低。总的来说，与传统的镇静剂，催眠药和阿片类药物相比，右美托咪定对门诊白内障手术的镇痛效果更好，患者满意度更高，眼压降低。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。右美托咪定通常报告有更好的镇痛作用和更高的患者满意度，以及IOP降低。总的来说，与传统的镇静剂，催眠药和阿片类药物相比，右美托咪定对门诊白内障手术的镇痛效果更好，患者满意度更高，眼压降低。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。催眠药和阿片类药物。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。催眠药和阿片类药物。然而，必须权衡右美托咪定的这些益处与相对的心血管抑制和延迟的PACU排出或恢复时间。因此，右美托咪定在门诊白内障手术中的实用性应逐个患者考虑。