ABSTRACT
Background and Objective
A systematic review and meta‐analysis of randomised controlled trials was undertaken to evaluate the effect of intrathecal dexmedetomidine (DEX) on the duration of postoperative analgesia, postoperative pain scores and incidences of adverse effects.
Databases and Data Treatment: Database search was performed from inception until January 2019. All randomised controlled trials analysing acute postoperative pain characteristics after intrathecal DEX administration in adults undergoing spinal anaesthesia for elective surgery were included. The primary outcome was postoperative analgesic duration, defined as the time to first analgesic request. The secondary outcomes included pain scores at 6, 12, and 24 post‐operative hours and rates of hypotension, bradycardia, shivering and postoperative nausea and vomiting.
Results
Twenty‐four studies comprising a total of 1460 patients were included. Postoperative analgesic duration was prolonged with intrathecal DEX compared to placebo, with a pooled mean difference of 191.3 minutes (95% CI 168.8 to 213.8). Patients who received intrathecal DEX reported lower Visual Analogue Scale (VAS) scores at 24 postoperative hours compared with those patients receiving placebo, with a mean difference (95% CI) of ‐1.05 (‐1.89 to ‐0.20, p=0.02). There were no differences in the incidence of adverse effects, except for a lower rate of postoperative shivering in the intrathecal DEX group (pooled RR 0.58, 95% CI 0.34 to 0.98, p=0.04).
Conclusions
Compared to placebo, intrathecal DEX prolonged postoperative analgesic duration, reduced 24‐hour pain intensity and reduced the incidence of shivering without an increase in other adverse effects.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2zwRDrf
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