Meta-analysis of dopexamine and its effect on mortality in patients undergoing major surgery

Introduction

Dopexamine hydrochloride is a synthetic dopaminergic agent with predominant DA-1 and β-2 agonist properties. Studies using dopexamine in the perioperative period have yielded conflicting results. One published systematic review discussed only the effect of dopexamine on renal and hepatosplanchnic perfusion. Hence, we conducted a meta-analysis to investigate the effect of dopexamine on mortality in patients undergoing major abdominal surgery.

Methods

Embase (1974–July 2007), Medline (1950–July 2007), CINAHL, PubMed, and CENTRAL were searched using the MeSH term 'Dopexamine'. Four out of the 42 potentially eligible studies fulfilled the inclusion criteria. A total of 851 patients were included in these four studies. The data were pooled and entered into Revman 4.2 for further analysis. A random effects model was used and the results are reported as relative risks (RR) with 95% CI.

Results

Mortality was not significantly different with dopexamine treatment (RR = 0.61, 95% CI = 0.32–1.18; P = 0.14). Subgroup analysis involving the studies that used low-dose (≤ 1 μg/kg/min) dopexamine failed to show any benefit. See Figure 1.

Figure 1

Conclusion

Dopexamine does not improve mortality in patients undergoing major abdominal surgery. The benefits of a particular dose of administration remain uncertain because of the limited number of studies included in this meta-analysis. Further well-powered multicentre randomised controlled clinical trials will be needed to address this.