title: Effects of Combining Dexmedetomidine and Opioids for Postoperative Intravenous Patient-controlled Analgesia: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  This meta-analysis evaluated the effects of opioid-dexmedetomidine (DEX) combinations for postoperative patient-controlled analgesia (PCA).
  
  
  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.
  
  
  RESULTS
  Seven 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).
  
  
  CONCLUSIONS
  These data suggest that an opioid-DEX combination is a safe and effective strategy for postoperative intravenous PCA.
authors: Department of Anaesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China.
authors: Ke
authors: K
authors: Peng
authors: Hua-Yue
authors: HY
authors: Liu
authors: Shao-Ru
authors: SR
authors: Wu
authors: Hao
authors: H
authors: Cheng
authors: Fu-Hai
authors: FH
authors: Ji
mesh_terms: D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D020927:Dexmedetomidine