• Ke Peng, Hua-Yue Liu, Shao-Ru Wu, Hao Cheng, and Fu-Hai Ji.
• Department of Anaesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China.
• Clin J Pain. 2015 Dec 1; 31 (12): 1097-104.

ObjectivesThis meta-analysis evaluated the effects of opioid-dexmedetomidine (DEX) combinations for postoperative patient-controlled analgesia (PCA).Materials And MethodsA systematic literature search was conducted to identify randomized controlled trials comparing opioid-DEX combinations to opioid alone for intravenous PCA up to postoperative 24 hours in adult patients. Outcomes included postoperative pain intensity, opioid consumption, and adverse events.ResultsSeven randomized controlled trials were included. Compared with opioid alone, postoperative intravenous opioid-DEX combination PCA strategies led to lower postoperative pain intensity (mean difference(4 h)=-0.83 [on a 0 to 10 scale], 95% confidence interval [CI]: -1.34 to -0.32, P=0.002), lower postoperative morphine-equivalent consumption (mean difference(0-24 h)=-16.46 mg, 95% CI: -23.65 to -9.27, P<0.00001), and lower incidence of postoperative nausea (risk ratio [RR]=0.42, 95% CI: 0.30 to 0.58, P<0.00001), vomiting (RR=0.38, 95% CI: 0.16 to 0.89, P=0.02), and pruritus (RR=0.59, 95% CI: 0.35 to 1.00, P=0.05). More patients were satisfied with PCA when opioids were combined with DEX (RR=1.14, 95% CI: 1.02 to 1.29, P=0.02).DiscussionThese data suggest that an opioid-DEX combination is a safe and effective strategy for postoperative intravenous PCA.

This article appears in the collection: Perioperative & Regional Dexmedetomidine.

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