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Ju JY, Kim KM, Lee S. Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis. Anesth Pain Med (Seoul). 2020;15(2):157-166doi: 10.17085/apm.2020.15.2.157.
Ju, J. Y., Kim, K. M., & Lee, S. (2020). Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis. Anesthesia and pain medicine, 15(2), 157-166. https://doi.org/10.17085/apm.2020.15.2.157
Ju, Ji Youn, et al. "Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis." Anesthesia and pain medicine vol. 15,2 (2020): 157-166. doi: https://doi.org/10.17085/apm.2020.15.2.157
Ju JY, Kim KM, Lee S. Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis. Anesth Pain Med (Seoul). 2020 Apr 30;15(2):157-166. doi: 10.17085/apm.2020.15.2.157. Epub 2020 Apr 29. PMID: 33329808; PMCID: PMC7713826.
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Anesth Pain Med (Seoul). 2020 Apr 30;15(2):157-166. doi: 10.17085/apm.2020.15.2.157. Epub 2020 Apr 29.

Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis.

Anesthesia and pain medicine

Ji Youn Ju, Kye-Min Kim, Sangseok Lee

Affiliations

  1. Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

PMID: 33329808 PMCID: PMC7713826 DOI: 10.17085/apm.2020.15.2.157

Abstract

BACKGROUND: Alpha-2 agonists have sedative, analgesic, and opioid-sparing effects. Moreover, intraoperative or postoperative systemic administration of alpha-2 adrenergic agonists is known to reduce postoperative pain and opioid consumption. This meta-analysis investigated whether preoperative administration of alpha-2 agonists can affect postoperative pain and opioid consumption.

METHODS: We searched the MEDLINE, EMBASE, Cochrane Library (CENTRAL), KoreaMed, and KMbase databases through March 2019 to identify relevant randomized controlled trials (RCTs) on the effect of preoperative systemic administration of alpha-2 agonists on postoperative pain and opioid consumption. We conducted a meta-analysis according to the Cochrane Collaboration guidelines. Standardized mean differences (SMDs) of postoperative pain intensity or dose of opioid consumption in the alpha-2 agonist group were extracted and combined using a random-effect model and were compared to those of the control group.

RESULTS: Eleven RCTs involving 748 participants were included in this meta-analysis. Preoperative administration of systemic alpha-2 agonists significantly reduced cumulative opioid consumption up to 6 h (SMD, -0.52; 95% confidence interval [-0.90 to -0.14]) and 24 h (SMD, -0.68 [-1.27 to -0.09]) after surgery. Moreover, preoperative administration of alpha-2 agonists significantly reduced postoperative pain intensity at 6 h (SMD, -0.50 [-0.78 to -0.21]) and 24 h (SMD, -0.44 [-0.86 to -0.03]).

CONCLUSIONS: In this meta-analysis, high degree of heterogeneity limits the preoperative administration of alpha-2 agonists in reducing postoperative opioid consumption and pain intensity. Future powered large RCTs are required to increase the certainty of evidence on the effect in reducing postoperative opioid consumption and pain intensity.

Copyright © the Korean Society of Anesthesiologists, 2020.

Keywords: Adrenergic alpha-2 receptor agonists; Analgesics, opioid; Anesthesia; Clonidine; Dexmedetomidine; Meta-analysis; Postoperative pain; Systematic review

Conflict of interest statement

CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported.

References

  1. Anesthesiology. 2012 Jun;116(6):1312-22 - PubMed
  2. Anesthesiology. 2005 Jun;102(6):1249-60 - PubMed
  3. Can J Anaesth. 2001 Nov;48(10):1000-10 - PubMed
  4. Rev Med Chir Soc Med Nat Iasi. 2013 Oct-Dec;117(4):934-41 - PubMed
  5. Anesth Analg. 2005 Dec;101(6):1634-42 - PubMed
  6. Anesth Analg. 2005 Nov;101(5):1374-80 - PubMed
  7. Pain. 2003 Oct;105(3):415-23 - PubMed
  8. Anesthesiology. 2000 Nov;93(5):1345-9 - PubMed
  9. Pain. 2013 Jul;154(7):1140-9 - PubMed
  10. Acta Anaesthesiol Sin. 2000 Mar;38(1):23-9 - PubMed
  11. Eur J Anaesthesiol. 2005 May;22(5):386-91 - PubMed
  12. BMC Anesthesiol. 2018 Jan 5;18(1):3 - PubMed
  13. Korean J Anesthesiol. 2013 Aug;65(2):114-20 - PubMed
  14. J Surg Res. 2010 Mar;159(1):e11-6 - PubMed
  15. Indian J Anaesth. 2012 Jul;56(4):359-64 - PubMed
  16. Anaesthesia. 1999 Feb;54(2):146-65 - PubMed
  17. Anesth Analg. 2005 Nov;101(5):1343-8 - PubMed
  18. Fam Med. 2005 May;37(5):360-3 - PubMed
  19. BMJ. 2009 Jul 21;339:b2535 - PubMed
  20. Can J Anaesth. 2006 Jul;53(7):646-52 - PubMed
  21. Eur J Anaesthesiol. 1992 Jul;9(4):325-9 - PubMed
  22. Eur J Anaesthesiol. 2010 Apr;27(4):324-30 - PubMed

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