Effects of Combining Dexmedetomidine and Opioids for Postoperative Intravenous Patient-controlled Analgesia: A Systematic Review and Meta-analysis

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This meta-analysis evaluated the effects of opioid-dexmedetomidine (DEX) combinations for postoperative patient-controlled analgesia (PCA).

Materials and Methods:

A 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.


Seven randomized controlled trials were included. Compared with opioid alone, postoperative intravenous opioid-DEX combination PCA strategies led to lower postoperative pain intensity (mean difference4 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 difference0-24 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).


These data suggest that an opioid-DEX combination is a safe and effective strategy for postoperative intravenous PCA.

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