EFFICACY AND SAFETY OF DEXMEDETOMIDINE IN MANAGEMENT OF ALCOHOL WITHDRAWAL: EVIDENCE FROM A META-ANALYSIS

Abstract

PURPOSE:The role of dexmedetomidine in the management of alcohol withdrawal is not well established. We conducted a meta-analysis to assess the efficacy and safety of this drug for this purpose.METHODS:We performed a literature search of all published full-length articles that studied and compared data on utilization ofdexmedetomidine versus placebo in addition to the standard symptom triggered benzodiazepine use. Primary outcomes for thestudy were ICU length of stay and total length of hospitalization. Secondary outcomes were the adverse effects includingbradycardia and hypotension.RESULTS:A total of 5 studies, (2 randomized control trials and 3 retrospective studies) were included in the analysis. 250 patientsreceived the study drug from a total of 638 patients. There was no difference in the mean length of stay in ICU (Std meandifference 0.18; 95%CI [-1.24, 1.60], p-value 0.80) and total length of hospitalization(Std mean difference 0.20; 95%CI [-2.25, 2.657.07], p-value 0.87) between the case and control group. There was a non-significant trend toward more hypotensive episodes inthe case group (OR 2.61, 95% CI [0.96, 7.07]; p-value 0.06). The number of bradycardia episodes was significantly higher in thecase group (OR 7.89, 95% CI [2.19, 28.4]; p-value 0.002).CONCLUSIONS:Dexmedetomidine has no benefit and is associated with a higher incidence of adverse events for themanagement of alcohol withdrawal.CLINICAL IMPLICATIONS:At present, there is no compelling evidence to support dexmedetomidine in the management ofalcohol withdrawal. Further studies are required to assess any additional benefits of this drug.DISCLOSURE:No significant relationships.