title: Dexmedetomidine Reduces Perioperative Opioid Consumption and Postoperative Pain Intensity in Neurosurgery: A Meta-analysis.
abstract: BACKGROUND
  Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients.
  
  
  METHODS
  A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery. PubMed, the Web of science, the Cochrane Library, and Scopus were searched. The resulting data were combined to calculate the pooled mean differences (MDs), standard MDs or odds ratios (ORs), and 95% confidence intervals (CIs), as appropriate. Heterogeneity and potential publication bias were assessed. Furthermore, a trial sequential analysis was performed to improve the precision of our findings.
  
  
  RESULTS
  A total of 11 published RCTs involving 674 patients undergoing neurosurgery (335 patients, 339 controls) were included in this meta-analysis. There were significant differences in postanesthesia care unit (PACU) visual analog scale scores between the groups (MD=-1.54, 95% CI, -2.33 to 0.75, I=87%, P=0.0001). In addition, there were significant differences in PACU opioid requirements between the treatment and control groups (standard MD=-0.88, 95% CI, -1.74 to 0.02, I=91%, P=0.05). Furthermore, intraoperative opioid consumption was significantly reduced in the treatment group (MD=-127.75, 95% CI, -208.62 to 46.89, I=98%, P=0.002).
  
  
  CONCLUSIONS
  DEX could reduce perioperative and PACU opioid consumption as well as postoperative pain intensity.
authors.affiliation: Departments of Anesthesiology.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Neurosurgery, the First Affiliated Hospital.
authors.forename: Feng
authors.initials: F
authors.lastname: Liang
authors.affiliation: Medical College.
authors.forename: Xiaochen
authors.initials: X
authors.lastname: Liu
authors.affiliation: Departments of Anesthesiology.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Shao
authors.affiliation: Departments of Anesthesiology.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Gan
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D020927:Dexmedetomidine; D006801:Humans; D006993:Hypnotics and Sedatives; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control*; D059035:Perioperative Period
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine