Comparison of Dexmedetomidine and Midazolam-Fentanyl for Sedation and Analgesia During Surgery: A Systematic Review and Meta-Analysis - Summary - MDSpire

Comparison of Dexmedetomidine and Midazolam-Fentanyl for Sedation and Analgesia During Surgery: A Systematic Review and Meta-Analysis

  • By

  • Hashim Talib Hashim

  • Mostafa A. Khalifa

  • Aya Ahmed Shimal

  • Marafi Jammaa Ahmed

  • Mohamed H. Elbadawi

  • Khadeeja Ali Hamzah

  • Abdulhadi M. A. Mahgoub

  • Alaa R. AL-Ihribat

  • Salem Waleed Salem Mohamed

  • Fathima Raahima Riyas Mohamed

  • Elian Khalafalla

  • Amna Kamil

  • Anzah Imtiaz Wagga

  • Ahmed Mohamed Shahin

  • Abdelrhman H. Mohammed

  • March 27, 2026

  • 0 min

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Objective:

To compare the efficacy, safety, and patient outcomes of dexmedetomidine versus midazolam-fentanyl for sedation and analgesia in surgical patients.

Key Findings:
  • Dexmedetomidine significantly lowered mean arterial pressure (MAP) by −6.42 mmHg.
  • After excluding an outlier, dexmedetomidine reduced heart rates by 6.71 bpm.
  • No significant differences in respiratory rate and oxygen saturation between groups.
  • Adverse events were comparable between dexmedetomidine and midazolam-fentanyl.
Interpretation:

Dexmedetomidine provides better blood pressure control compared to midazolam-fentanyl while maintaining similar safety profiles for respiratory parameters.

Limitations:
  • Only 4 RCTs with 259 patients were included.
  • Sensitivity analyses may not fully address all sources of bias.
  • Long-term outcomes such as postoperative delirium were not assessed.
Conclusion:

Dexmedetomidine is a promising alternative to midazolam-fentanyl for sedation during surgery, warranting further research on long-term outcomes.

Original Source(s)

Comparison of Dexmedetomidine and Midazolam-Fentanyl for Sedation and Analgesia During Surgery: A Systematic Review and Meta-Analysis

  • by Hashim Talib Hashim, Mostafa A. Khalifa, Aya Ahmed Shimal, Marafi Jammaa Ahmed, Mohamed H. Elbadawi, Khadeeja Ali Hamzah, Abdulhadi M. A. Mahgoub, Alaa R. AL-Ihribat, Salem Waleed Salem Mohamed, Fathima Raahima Riyas Mohamed, Elian Khalafalla, Amna Kamil, Anzah Imtiaz Wagga, Ahmed Mohamed Shahin, Abdelrhman H. Mohammed

  • March 27, 2026

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