SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Cognitive and Behavioral Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1605999
Effect of dexmedetomidine on postoperative cognitive function in patients with gastrointestinal cancer: A meta-analysis of randomized controlled trials
Provisionally accepted- 1Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- 2Shenzhen TCM Anorectal Hospital (Futian), Shenzhen, China
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Introduction: This meta-analysis was conducted to systematically evaluate the effects of dexmedetomidine (DEX) on mini-mental state examination (MMSE) scores and the incidence of postoperative cognitive dysfunction (POCD) in patients with gastrointestinal cancers (GICs) undergoing radical surgery (RS), by aggregating data from randomized controlled trials (RCTs). Methods: A comprehensive literature review was undertaken that encompassed seven databases from their inception until March 4, 2024. The quality of the studies was assessed using the Cochrane Collaboration tool to evaluate risk. Based on the heterogeneity determined through Cochran's Q and I² tests, either fixed-effect or random-effect models were employed to conduct the appropriate meta-analyses. Publication bias was assessed using the Egger test, while the stability of the results was evaluated through a one-by-one elimination method. Results: A total of twelve studies involving 881 patients with GIC (440 patients treated with DEX and 441 patients receiving saline) were included in this meta-analysis. The overall quality of the included studies was deemed moderate. The application of a random-effect model indicated that DEX significantly elevated MMSE scores on postoperative days 1, 2, 3, and 7, albeit with considerable heterogeneity. Conversely, the fixed-effect model demonstrated a protective effect of DEX on the incidence of POCD. Nonetheless, subgroup analyses stratified by cancer type and surgical method did not identify the sources of heterogeneity. The Egger test revealed no evidence of publication bias across the included studies (P = 0.447). Sensitivity analyses further confirmed the robustness of the findings of this meta-analysis. Discussion: The findings suggest that DEX exerts a protective effect on cognitive function in patients with GICs undergoing RS. Nevertheless, high-quality, large-scale RCTs are necessary to furnish more definitive evidence.
Keywords: Dexmedetomidine, gastrointestinal cancer, postoperative cognitive function, metaanalysis, Mini-mental state examination
Received: 04 Apr 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Zheng, Lan, Chen, Du and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiaxuan Wu, Shenzhen TCM Anorectal Hospital (Futian), Shenzhen, China
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