This study investigated the efficacy and safety of intravenous dexmedetomidine as an adjuvant to general anesthesia in patients undergoing gynecological surgery. We systemically searched for randomized controlled trials (RCTs), and performed a meta-analysis on studies that met the inclusion criteria. The primary outcomes were postoperative nausea and vomiting (PONV), bradycardia, hypotension, and 24 h opioid consumption. The secondary outcomes include postoperative shivering, postoperative pain score, intraoperative anesthetic consumption, extubation time, postoperative sedation, and the time to first flatus. Twenty-five RCTs were included in this study. Meta-analysis showed that intravenous dexmedetomidine significantly reduced the risk of PONV (RR, 0.57 [0.47, 0.68]) and postoperative shivering (RR: 0.31 [0.22, 0.42]), 24 h opioid consumption (Mean Difference: - 4.85 mg [-8.60, -1.11]) and postoperative pain score within 24 h. However, these benefits were at the cost of increased bradycardia (RR, 3.21 [2.41, 4.28]) and hypotension (RR, 2.17 [1.50, 3.14]). Notably, no serious adverse effects were reported in any of the included studies. Thus, our study showed that intravenous dexmedetomidine provided significant antiemetic and anti-shivering effects and moderate analgesic effects in patients that underwent gynecological surgery. However, its benefits should be weighed against the significantly increased risk of bradycardia and hypotension.
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http://dx.doi.org/10.1016/j.tjog.2022.11.010 | DOI Listing |
Surg Neurol Int
December 2024
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background: Propofol is one of the most used intravenous anesthetic agents in traumatic brain injury (TBI) patients undergoing emergency neurosurgical procedures. Despite being efficacious, its administration is associated with dose-related adverse effects. The use of adjuvants along with propofol aids in limiting its consumption, thereby mitigating the side effects related to propofol usage.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anaesthesiology, Affiliated Hospital of North Sichuan medical college, Nanchong, Sichuan, China.
The effect of epidural infusion of dexmedetomidine on haemodynamics is unclear. This study aimed to explore the effects of epidural or intravenous infusion of dexmedetomidine on haemodynamics during lower extremity varicose veins surgery (saphenectomy) under epidural anaesthesia. Ninety patients were randomly allocated to three groups: ED group (epidural: 0.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cancer recurrence and metastasis remain critical challenges following surgical resection, influenced by complex perioperative mechanisms. This review explores how surgical stress triggers systemic changes, such as neuroendocrine responses, immune suppression, and inflammation, which promote the dissemination of residual cancer cells and circulating tumor cells. Key mechanisms, such as epithelial-mesenchymal transition and angiogenesis, further enhance metastasis, while hypoxia-inducible factors and inflammatory responses create a microenvironment conducive to tumor progression.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
April 2024
Department of Anaesthesia and Intensive Care, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, Telangana, India.
Background And Aims: Intravenous sedation during spinal anesthesia has the advantages of increased duration of spinal anesthesia and better postoperative pain control. The aim of this study was to compare the effect of intravenous bolus and infusion of dexmedetomidine versus ketamine given intraoperative on the postoperative analgesia in fracture femur patients operated under subarachnoid block.
Material And Methods: In this prospective randomized double-blind controlled study, 75 patients aged 18-65 years posted for elective surgery were selected and randomly divided into three groups to receive ketamine (group K), dexmedetomidine (group D), and saline (control group C).
Anesth Analg
January 2025
Department of Anesthesiology, Cincinnati Children's Hospital, Cincinnati, Ohio.
Background: Posterior spinal fusion (PSF) surgery for correction of idiopathic scoliosis is associated with chronic postsurgical pain (CPSP). In this multicenter study, we describe perioperative multimodal analgesic (MMA) management and characterize postoperative pain, disability, and quality of life over 12 months after PSF in adolescents and young adults.
Methods: Subjects (8-25 years) undergoing PSF were recruited at 6 sites in the United States between 2016 and 2023.
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