eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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abstract:
Original paper

Effect of dexmedetomidine on opioid consumption and pain control after laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials

Yang Liu
1
,
Guomin Zhao
1
,
Xuefeng Zang
1
,
Feiping Lu
1
,
Ping Liu
1
,
Wei Chen
1

1.
Department of Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Videosurgery Miniinv
Online publish date: 2021/03/08
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Introduction
The clinical evidence on dexmedetomidine (DEX) for postoperative pain scores and opioid consumption remains unclear in laparoscopic cholecystectomy (LC). Aim: To evaluate whether DEX could reduce opioid consumption and pain control after LC.

Material and methods
A meta-analysis search of EMBASE, PubMed and Cochrane CENTRAL databases was performed and randomized controlled trials (RCTs) comparing DEX with control for adult patients undergoing LC were searched. The primary outcome was opioid consumption in the first 24 h after the operation. The secondary outcomes were the time of first request of analgesia, visual analogue scale (VAS) scores 24 h after the operation, the incidence of patients’ need for rescue analgesics, opioid-related adverse effects, DEX-related adverse effects and other complications.

Results
There were fourteen aspects of twelve trials and 967 patients included in the analysis. DEX use significantly reduced the opioid consumption in the first 24 h after the operation (weighted mean difference (WMD), –19.17; 95% confidence interval (CI), –30.29 to –8.04; p = 0.0007), lengthened the time of first request of analgesia (WMD = 38.90; 95% CI: 0.88–76.93; p = 0.04) and lowered post-operative nausea or vomiting (PONV) (odds ratio (OR) = 0.49; 95% CI: 0.27–0.89; p = 0.02).

Conclusions
Intravenous DEX infusion significantly improved the duration of the analgesic effect and reduced postoperative opioid consumption. Moreover, lower incidence of post-operative nausea or vomiting was found in the DEX group.

keywords:

dexmedetomidine; pain; opioid consumption; visual analogue scale; meta-analysis

  
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