Dexmedetomidine and sufentanil combination versus sufentanil alone for postoperative intravenous patient-controlled analgesia: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Previous studies have demonstrated that dexmedetomidine improves the quality of postoperative analgesia. In the present study, we performed a meta-analysis of randomized controlled trials to quantify the effect of dexmedetomidine as an adjuvant to sufentanil for postoperative patient-controlled analgesia (PCA). Methods PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched for randomized controlled trials in which dexmedetomidine was used as an adjuvant for PCA with sufentanil. In the retrieved studies, we quantitatively analyzed pain intensity, sufentanil consumption, and drug-related side effects. Results Nine studies with 907 patients were included in this meta-analysis. Compared with sufentanil alone, dexmedetomidine-sufentanil for postoperative intravenous PCA reduced pain intensity at 24 h (mean difference (MD) = − 0.70points; 95% confidence interval (CI): − 1.01, − 0.39; P < 0.00001) and 48 h postoperatively (MD = -0.61points; 95% CI: − 1.00, − 0.22; P = 0.002). Moreover, dexmedetomidine-sufentanil reduced sufentanil consumption during the first 24 h (MD = -13.77 μg; 95% CI: − 18.56, − 8.97; P < 0.00001) and 48 h postoperatively (MD = -20.81 μg; 95% CI: − 28.20, − 13.42; P < 0.00001). Finally, dexmedetomidine-sufentanil improved patient satisfaction without increasing the incidence of side effects. Conclusions Dexmedetomidine as an adjuvant to sufentanil for postoperative PCA can reduce postoperative pain score and sufentanil consumption.

Sufentanil Reduces Emergence Delirium in Children Undergoing Transthoracic Device Closure of VSD After Sevoflurane-Based Cardiac Anesthesia

“…Clinical studies have shown that sufentanil has the highest therapeutic index of all opioids [ 23 ] . As a result, sufentanil can provide stronger analgesic effects over a longer period than the same dose of fentanyl or morphine and can reduce respiratory depression and the incidence of adverse reactions [ 6 , 23 ] . Li and his team reported that administration of sufentanil could reduce emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared to fentanyl, without delaying the recovery time or causing significant hypotension [ 24 ] .…”

“…Sufentanil has a strong analgesic capacity and sedative effect and lasts longer [ 5 ] . It has a mild effect on the cardiovascular system and no effect on histamine release, so it can effectively reduce postoperative pain in children [ 6 ] . Therefore, it is widely used in the induction and maintenance of anesthesia in pediatric cardiac surgery.…”

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

“…11,12 Recent studies have confirmed that DEX can be used in the perioperative period of cesarean section to assist analgesia. 13,14 There are also studies reporting the effect of DEX on improving mood. 15,16 Furthermore, it is worth mentioning that DEX can act on the locus coeruleus and thus produce a sedative effect similar to natural sleep by activating endogenous sleep pathways.…”

SOP Schmerztherapie auf der Intensivstation

“…Clonidin und Dexmedetomedin haben neben ihren antideliranten und sedierenden Eigenschaften auch eine koanalgetische Wirkung. Durch die Verwendung von Alpha-2-Agonisten verringert sich die Gefahr der opioidinduzierten Hyperalgesie [28] und es können Opioide eingespart werden [29,30]. Zu beachten ist die Gefahr der Hypotension und der Bradykardie.…”