O USO DE DEXMEDETOMIDINE NA REDUÇÃO DOS SINTOMAS DE DELIRIUM E AGITAÇÃO PSICOMOTORA PÓS-ANESTESIA
DOI:
https://doi.org/10.66104/vrr9wh31Palabras clave:
Terapêutica; Anestesia; Agitação Psicomotora.Resumen
Introdução: O delirium é uma síndrome neuropsiquiátrica aguda e reversível, que pode cursar com agitação psicomotora, sendo comum em procedimentos pós-anestésicos. Objetivo: Avaliar, se em pacientes pós-anestesia, o uso da dexmedetomidine promove a redução nos sintomas de delirium e agitação psicomotora. Método: Será uma Revisão Sistemática de Prognóstico com a seguinte questão norteadora: “Os pacientes pós-anestesia, que usam dexmedetomidine, em comparação com outras terapias, têm redução nos sintomas de delirium e agitação psicomotora?”. Após isso, acontecerá a procura nas bases de dados utilizando os DeCS - Anesthesia or "Geriatric Anesthesia" or "Anesthesia, General" and Delirium and "Psychomotor Agitation" and Dexmedetomidine - por conseguinte a aplicação dos critérios de elegibilidade, excluindo-se aqueles duplicados, que não responderão à pergunta e estudos realizados em animais para composição da amostra final. Resultados: A dexmedetomidina demonstrou redução consistente da agitação psicomotora e no delirium, quando utilizada de forma contínua ou prolongada. Os efeitos foram mais evidentes em regimes perioperatórios e em UTI, com bom perfil de segurança. Conclusão: A dexmedetomidina é uma estratégia eficaz e segura para reduzir agitação e delirium, especialmente quando utilizada por períodos prolongados.
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ABDEL-RAHMAN, K. A.; ABD-ELSHAFY, S. K.; SAYED, J. A. Effect of two different doses of dexmedetomidine on the incidence of emergence agitation after strabismus surgery: a randomized clinical trial. Brazilian Journal of Anesthesiology, v. 68, n. 6, p. 571–576, 2018. DOI: https://doi.org/10.1016/j.bjan.2018.05.002.
CARVALHO, L. A. Fisiopatologia do delirium no perioperatório: além dos neurotransmissores. Revista de Medicina, São Paulo, v. 102, n. 2, p. 1–10, 2023. DOI: https://doi.org/10.11606/issn.1679-9836.v102i2p1-10.
CHEN, X. et al. Comparison of remimazolam and dexmedetomidine on postoperative delirium and emergence agitation in elderly patients undergoing thoracoscopic surgery: a randomized, double-blind, non-inferiority trial. Drug Design, Development and Therapy, v. 19, p. 9671–9681, 2025. DOI: https://doi.org/10.2147/DDDT.S548418.
DUTTA, S. et al. Dexmedetomidine in perioperative care: current evidence and future perspectives. Journal of Clinical Anesthesia, v. 88, p. 111097, 2024. DOI: https://doi.org/10.1016/j.jclinane.2023.111097.
GOVÊIA, C. S. et al. Dexmedetomidine reduces postoperative cognitive and behavioral dysfunction in adults submitted to general anesthesia for non-cardiac surgery: meta-analysis of randomized clinical trials. Brazilian Journal of Anesthesiology, v. 71, n. 4, p. 413–420, 2021. DOI: https://doi.org/10.1016/j.bjane.2021.02.020.
GUO, Y. et al. [Título não especificado]. Shanghai Journal of Stomatology, v. 24, n. 2, p. 236–239, 2015.
HIGGINS, J. P. T. et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, v. 343, p. d5928, 2011. DOI: https://doi.org/10.1136/bmj.d5928
HONÓRIO, H. M; SANTIAGO JUNIOR, J. F.; PERALYA-MAMANI, M. Análise qualitativa da revisão sistemática. In: HONÓRIO, H. M; SANTIAGO JUNIOR, J. F. Fundamentos das revisões sistemáticas. São Paulo: Editora Quintessence, p. 205-231, 2021.
HU, Y. et al. The neuroprotective effect of dexmedetomidine and its mechanism. Frontiers in Pharmacology, v. 13, p. 965661, 2022. DOI: https://doi.org/10.3389/fphar.2022.965661.
INOUYE, S. K. et al. Delirium in older persons. New England Journal of Medicine, v. 384, n. 13, p. 1169–1177, 2021. DOI: https://doi.org/10.1056/NEJMra2107033.
KOTFIS, K.; ELY, E. W. Delirium: an update on diagnosis, prevention, and management. Current Opinion in Critical Care, v. 28, n. 2, p. 167–175, 2022. DOI: https://doi.org/10.1097/MCC.0000000000000934.
KOTFIS, K.; ELY, E. W. Delirium: an update on diagnosis, prevention, and management. Current Opinion in Critical Care, v. 28, n. 2, p. 167–175, 2022. DOI: https://doi.org/10.1097/MCC.0000000000000934.
LIAQUAT, Z. et al. The current role of dexmedetomidine as neuroprotective agent: an updated review. Brain Sciences, v. 11, n. 7, p. 846, 2021. DOI: https://doi.org/10.3390/brainsci11070846.
MAIA, A. S. et al. Quadros de delírium em pacientes de terapia intensiva e a associação com sedoanalgesia: uma revisão bibliográfica. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 1, p. 1479–1491, 2024. DOI: https://doi.org/10.47820/bjihs.v6i1.1293.
NEEDHAM, M. J. et al. Anaesthesia, surgery, and postoperative cognitive dysfunction and delirium: a narrative review. British Journal of Anaesthesia, v. 130, n. 3, p. 456–469, 2023. DOI: https://doi.org/10.1016/j.bja.2022.12.009.
NG, K. T.; SHUBASH, C. J.; CHONG, J. S. The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis. Anaesthesia, v. 74, n. 3, p. 380–392, 2019. DOI: https://doi.org/10.1111/anae.14472.
OH, E. S. et al. Preoperative risk factors for postoperative delirium following hip fracture repair: a systematic review. Journal of the American Geriatrics Society, v. 70, n. 2, p. 363–372, 2022. DOI: https://doi.org/10.1111/jgs.17576.
OUZZANI, M.; HAMMADY, H.; FEDOROWICZ, Z.; ELMAGARMID, A. Rayyan — a web and mobile app for systematic reviews. Systematic Reviews, v. 5, n. 1, p. 210, 2016. DOI: https://doi.org/10.1186/s13643-016-0384-4
PENG, K. et al. Effect of perioperative dexmedetomidine on delirium after cardiac surgery: a meta-analysis with trial sequential analysis of randomized controlled trials. Frontiers in Medicine, v. 10, p. 1188472, 2023. DOI: https://doi.org/10.3389/fmed.2023.1188472.
SAHNI, N. et al. Postoperative delirium in elderly surgical patients: incidence, risk factors, and outcomes. Anesthesia & Analgesia, v. 134, n. 1, p. 76–86, 2022. DOI: https://doi.org/10.1213/ANE.0000000000005750.
SATTAR, L. et al. Comparison between dexmedetomidine and propofol for sedation on outcomes after cardiac surgery in patients requiring mechanical ventilation: a meta-analysis of randomized-controlled trials. Cureus, v. 15, n. 7, e42212, 2023. DOI: https://doi.org/10.7759/cureus.42212.
SU, X. et al. Dexmedetomidine for prevention of postoperative delirium in elderly patients undergoing non-cardiac surgery: a randomized, double-blind, placebo-controlled trial. The Lancet, v. 395, n. 10225, p. 1893–1902, 2020. DOI: https://doi.org/10.1016/S0140-6736(20)30766-6.
TANG, S. et al. The effect of dexmedetomidine on emergence delirium of postanesthesia events in pediatric department: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore), v. 103, n. 36, e39337, 2024. DOI: https://doi.org/10.1097/MD.0000000000039337.
URBANĚK, L. et al. Postoperative delirium. Rozhledy v chirurgii, v. 102, n. 10, p. 381–386, 2023. DOI: https://doi.org/10.33699/PIS.2023.102.10.381-386.
WANG, Y. et al. Dexmedetomidine effect on delirium in elderly patients undergoing general anesthesia: a protocol for systematic review and meta-analysis. Medicine, v. 100, n. 48, e27782, 2021. DOI: https://doi.org/10.1097/MD.0000000000027782.
WANG, Y. et al. Esketamina intranasal mais dexmedetomidina versus dexmedetomidina sozinha para delírio de emergência em pacientes pediátricos: uma revisão sistemática e meta-análise de ensaios clínicos randomizados. BMC Anesthesiology, v. 26, p. 114, 2026. DOI: https://doi.org/10.1186/s12871-026-03628-y.
WU, H. et al. Effect of different intranasal dexmedetomidine doses on pediatric postoperative delirium and agitation: network meta-analysis. Pediatric Research, v. 98, n. 4, p. 1266–1275, 2025. DOI: https://doi.org/10.1038/s41390-025-03851-2.
YAHYA, C. Q. et al. Emergence agitation in pediatrics after dexmedetomidine vs. sevoflurane anesthesia: a randomized controlled trial. PLOS One, v. 20, n. 10, e0333576, 2025. DOI: https://doi.org/10.1371/journal.pone.0333576.
YI, W. et al. The effect of two different doses of dexmedetomidine to prevent emergence agitation in children undergoing adenotonsillectomy: a randomized controlled trial. Brazilian Journal of Anesthesiology, v. 72, n. 1, p. 63–68, 2022. DOI: https://doi.org/10.1016/j.bjane.2021.08.019.
ZHAO, Y. et al. Study on the sedative effect of dexmedetomidine in radical prostatectomy: a retrospective study. Medicine, v. 104, n. 32, e43427, 2025. DOI: https://doi.org/10.1097/MD.0000000000043427
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