PONE-D-20-14846

Dexmedetomidine use in pediatric strabismus surgery: A systematic review and meta-analysis

PLOS ONE

Dear Dr. Hsu,

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PLOS ONE

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Additional Editor Comments (if provided):

Subanalyses on low-risk of bias studies would add value to your results and a TSA analysis would allow the reader to assess if the data are convincing enough to prove the effect.

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Reviewers' comments:

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: I have read with pleasure the manuscript entitled: "Dexmedetomidine use in pediatric strabismus surgery: A systematic review and metaanalysis". It is a well written and conducted meta analysis. I have only some minor remarks:

Most of the paragraph about study charachteristics repeat data reported in Table 1. They are unnecessary, please cut this paragraph removing duplication of data.

In methods state if subgroup analysis was pre-planned and it was a post-hoc analysis. Moreover, I do not find subgroup analysis with one or two studies appropriated. It seem more reasonable to state that there were not enough studies to perform a meta-analysis.

I suggest adding a post-hoc analysis with low risk of bias trials.

page 26 line 345 :"Our results indicated that compared with placebo use, perioperative use of dexmedetomidine in pediatric strabismus surgery might reduce the.. " Un-necessary repetition, I suggest to remove this sentence.

Reviewer #2: Chiang and coauthors performed a nice systematic review and meta-analysis investigating the use of dexmedetomidine in pediatric strabismus surgery. Within the nine included studies, they found a reduction in emergence agitation, postoperative nausea and vomiting, and postoperative pain in patients treated with dexmedetomidine.

The study was conducted in accordance with PRISMA guidelines and prospectively registered in the PROSPERO database.

All relevant studies appear to be included. The statistics appear to be well-conducted and complete.

The paper is presented in an intelligible fashion and well-written.

The authors should be complimented for their effort. I don't have any suggestion for modifications.

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Reviewer #1: No

Reviewer #2: Yes: Pasquale Nardelli, MD

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Dexmedetomidine use in pediatric strabismus surgery: A systematic review and meta-analysis

PONE-D-20-14846R1

Dear Dr. Hsu,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Laura Pasin

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: