Abstract: PURPOSE: To evaluate the efficacy of dexmedetomidine and midazolam, ketamine or placebo administrated in outpatient dental surgery. METHODS: PubMed, Embase, Cochrane Library and Web of Science were searched from inception to October 2017,to find all randomized controlled trials(RCTs) about the sedative effect of dexmedetomidine versus midazolam, ketamine or placebo during outpatient dental surgery. The quality of the studies was evaluated by the method recommended by Cochrane collaboration. Meta analysis was conducted using Review Manager 5.3 software. RESULTS: Twelve clinical trials with 678 patients were included. The results of meta analysis showed that the sedation score of children was lower in group of dexmedetomidine than that of group of normal saline (SMD=-1.73,95%CI:-2.70~-0.77,P=0.0004) and the sedation score of adults was also lower in group of dexmedetomidine than that of group of normal saline(SMD=-2.23,95%CI:-4.39~-0.08,P=0.04).There was no significant difference in sedation satisfaction of children between dexmedetomidine and ketamine(RR=1.14,95%CI:1.00-1.30,P=0.05).Dexmedetomidine provided more satisfactory sedation of children than midazolam(RR=1.38,95%CI:1.15-1.67,P=0.0006),and there was no significant difference in sedation satisfaction of adults between dexmedetomidine and midazolam (RR=1.42,95%CI:0.86-2.33,P=0.17). Moreover,dexmedetomidine provided more satisfactory behavior of children than ketamine (RR=1.19,95%CI:1.03-1.36,P=0.01) and midazolam (RR=1.28,95%CI:1.07-1.54,P=0.008). CONCLUSIONS: Compared with other sedative drugs, dexmedetomidine may be a better choice for moderate sedation during outpatient dental surgery.

Key words: Dexmedetomidine, Sedation, Dental surgery, Meta analysis