The effectiveness of dexmedetomidine on respiratory adverse events, overall use of narcotics, and pain levels in perioperative patients with obstructive sleep apnea: a systematic review protocol

Abstract

Review question/objective The objectives are to evaluate whether the use of dexmedetomidine in obstructive sleep apnea patients decreases: a)respiratory adverse events, b)overall use of narcotics, c)and pain levels Inclusion criteria Types of participants This review will consider studies that include adult surgical patients (ages 18 years and older) who are diagnosed with obstructive sleep apnea or who are at risk for obstructive sleep apnea as determined utilizing the STOP BANG questionnaire and who had surgery in the past 48 hours. Types of intervention(s)/phenomena of interest This review will evaluate the effectiveness of dexmedetomidine on pain levels, amount of narcotic pain medication use and adverse respiratory events on adult patients with obstructive sleep apnea for up to 48 hours following surgery. Studies that compare perioperative (pre-, intra- or postoperative) administration of dexmedetomidine to narcotics, other analgesics, and placebo will be considered. All modes of dexmedetomidine administration and all variations of dosage, frequency and duration will be included as well as interventions combining dexmedetomidine with another treatment if that same treatment, without dexmedetomidine, is also given to the control group. Types of outcomes This review will consider studies that include the following outcome measures: amount of narcotic pain medication use, adverse respiratory events which include rates of oxygen desaturations and episodes of respiratory depression, and patient level of pain. For the purposes of this review, respiratory depression is defined as a respiratory rate of less than 8 breaths per minute and oxygen desaturation is defined as oxygen saturation levels of less than 90%.