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Cochrane Database of Systematic Reviews

Alpha‐2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery

This is not the most recent version

view the current version 06 March 2018

Information

DOI:
https://doi.org/10.1002/14651858.CD004126.pub2Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 07 October 2009see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:

  1. Cochrane Anaesthesia Group

Copyright:
  1. Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Duminda N Wijeysundera

    Correspondence to: Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada

    [email protected]

    [email protected]

  • Jennifer S Bender

    Department of Anaesthesia, St Jospeh's Health Centre, Toronto, Canada

  • W Scott Beattie

    Department of Anaesthesia, Toronto General Hospital, University Health Network, Toronto, Canada

Contributions of authors

Conceiving the review: Duminda N Wijeysundera (DNW), W Scott Beattie (WSB)
Co‐ordinating the review: DNW
Undertaking manual searches: DNW, Jennifer S Bender (JSB), WSB
Screening search results: DNW, JSB, WSB
Organizing retrieval of papers: DNW, JSB
Screening retrieved papers against inclusion criteria: DNW, JSB, WSB
Appraising quality of papers: DNW, JSB, WSB
Abstracting data from papers: DNW, JSB, WSB
Writing to authors of papers for additional information: DNW
Data management for the review: DNW
Entering data into Review Manager (RevMan 5.0): DNW, WSB
RevMan statistical data: DNW
Double entry of data: (data entered by person one: DNW; data entered by person two: WSB)
Interpretation of data: DNW, JSB, WSB
Statistical inferences: DNW, WSB
Writing the review: DNW, JSB, WSB
Performing previous work that was the foundation of the present study: DNW, JSB, WSB
Guarantor for the review (one author): DNW
Person responsible for reading and checking review before submission: DNW

Sources of support

Internal sources

  • Department of Anesthesia, University of Toronto, Canada.

External sources

  • Canadian Institutes of Health Research, Canada.

Declarations of interest

None known

Acknowledgements

Dr Wijeysundera is supported in part by a Clinician Scientist Award from the Canadian Institutes of Health Research (Ottawa Ontario, Canada). Dr Beattie is the Fraser Elliot Chair of Cardiac Anesthesiology at the University Health Network (Toronto Ontario, Canada). We are indebted to the following authors who responded to our questions regarding their publications: Drs M Fischler, RM Grounds, HM Loick, I Matot, P Myles, M Oliver, L Quintin, C Spies, P Talke, and A Wallace. We would also like to thank Mathew Zacharias, Marialena Trivella, Helen Higham, Peter Alston, and Janet Wale for their help and editorial advice during the preparation of this review.

Version history

Published

Title

Stage

Authors

Version

2018 Mar 06

Alpha‐2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

Review

Dallas Duncan, Ashwin Sankar, W Scott Beattie, Duminda N Wijeysundera

https://doi.org/10.1002/14651858.CD004126.pub3

2009 Oct 07

Alpha‐2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery

Review

Duminda N Wijeysundera, Jennifer S Bender, W Scott Beattie

https://doi.org/10.1002/14651858.CD004126.pub2

2009 Jul 08

Alpha‐2 adrenergic agonists for the prevention of cardiovascular complications among patients undergoing cardiac or non‐cardiac surgery

Protocol

Duminda N Wijeysundera, Jennifer S Bender, W Scott Beattie

https://doi.org/10.1002/14651858.CD004126

Differences between protocol and review

Changes have been made between the current review and the original protocol. These changes include the following.

  1. Based on comments from a peer reviewer (Peter Alston), the title was changed from 'Alpha‐2 adrenergic agonists for the prevention of cardiovascular complications among patients undergoing cardiac or non‐cardiac surgery' to 'Alpha‐2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery'.

  2. We performed several post‐hoc analyses that were not specified in the original protocol.

    1. A subgroup analysis was performed based on drug type to explain the moderate heterogeneity (I2 = 34%) for the pooled effect of α‐2 adrenergic agonists on perioperative hypotension.

    2. We performed a post‐hoc subgroup analysis based on surgical procedure to explain the significant heterogeneity (I2 = 54%) for the pooled effect of α‐2 adrenergic agonists on perioperative bradycardia.

    3. Given the large influence of a single RCT of mivazerol (Oliver 1999), we performed a post‐hoc sensitivity analysis that excluded this study.

  3. We have added acute stroke as a secondary outcome (side‐effect from treatment) based on comments from a peer‐reviewer (Helen Higham) and the results of the POISE trial (POISE 2008). Specifically, the POISE trial found that perioperative beta‐blockers caused a significantly increased risk of perioperative acute stroke.

Notes

August 2016

This review has two included studies that have been retracted (Boldt 1996;Wahlander 2005).

The Cochrane authors are in the process of updating this review.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.