The impact of intra-operative dexmedetomidine infusion on immediate postoperative pain: a systematic review protocol

Abstract

Review question/objective The objective of this systematic review is to compare, translate, and analyze available research findings concerning the impact of intra-operative dexmedetomidine infusions on postoperative pain in the adult patient, during the first four hours after a general surgery procedure. Inclusion criteria Types of participants The review will consider studies that include patients over the age of 18 years of age, receiving general inhalation anesthesia. Patients must have had an infusion of dexmedetomidine intra-operatively during their procedure, with or without additional opioids. Patients must have been extubated (endotracheal tube removed) at the conclusion of the surgical procedure, in the operating room, to allow for immediate postoperative pain assessment. Therefore, patients transported directly to the PACU, or the intensive care unit (ICU), with endotracheal tubes in place will be excluded from this review. Variations will be allowed in the following categories due to a wide range of patient types, patient weights, co-morbidities, surgeon preferences/skills, anesthesia provider preferences/skills, unforeseen and uncontrollable intra-operative issues i.e., vital signs, variables, bleeding, etc. Types of intervention(s) The review will consider studies that examined the impact of intraoperative dexmedetomidine infusion, during a general inhalation anesthetic, with or without concomitant opioids, on immediate postoperative pain. Intra-operative dexmedetomidine infusions of all rates will be included. The comparator will be no intra-operative dexmedetomidine medication via any route during a general inhalation anesthetic. Types of outcomes The review will consider studies that include the following outcome measures: postoperative pain and medication requirements during the first four hours after surgery. Postoperative pain will be measured by patient reported Visual Analog Scores (VAS) during the first four postoperative hours.