{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:47:00Z","timestamp":1787932020412,"version":"build-2784847793"},"reference-count":65,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>A systematic review and meta\u2010analysis of randomized controlled trials (RCTs) was undertaken to evaluate the effect of intrathecal dexmedetomidine (DEX) on the duration of postoperative analgesia, postoperative pain scores and incidences of adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Databases and Data Treatment<\/jats:title><jats:p>Database search was performed from inception until January 2019. All RCTs analysing acute postoperative pain characteristics after intrathecal DEX administration in adults undergoing spinal anaesthesia for elective surgery were included. The primary outcome was postoperative analgesic duration, defined as the time to first analgesic request. The secondary outcomes included pain scores at 6, 12 and 24 postoperative hours and rates of hypotension, bradycardia, shivering and postoperative nausea and vomiting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010four studies comprising a total of 1,460 patients were included. Postoperative analgesic duration was prolonged with intrathecal DEX compared to placebo, with a pooled mean difference (MD) of 191.3\u00a0min (95% CI 168.8\u2013213.8). Patients who received intrathecal DEX reported lower Visual Analogue Scale scores at 24 postoperative hours compared with those patients receiving placebo, with a MD (95% CI) of \u22121.05 (\u22121.89 to \u22120.20, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). There were no differences in the incidence of adverse effects, except for a lower rate of postoperative shivering in the intrathecal DEX group (pooled relative risk 0.58, 95% CI 0.34\u20130.98, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to placebo, intrathecal DEX prolonged postoperative analgesic duration, reduced 24\u2010hr pain intensity and reduced the incidence of shivering without an increase in other adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The analgesic role of intrathecal DEX is promising due to its ability to significantly increase postoperative analgesic duration when compared with placebo. Its usage can be considered for patients undergoing surgeries with significant postoperative pain, particularly those intolerant of systemic analgesia. However, the optimal dose for various surgeries as well as its long\u2010term neurological effects warrants further studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1575","type":"journal-article","created":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T18:54:28Z","timestamp":1587840868000},"page":"1215-1227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Intrathecal dexmedetomidine and postoperative pain: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"24","author":[{"given":"Ambika","family":"Paramasivan","sequence":"first","affiliation":[{"name":"National University Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Lopez\u2010Olivo","sequence":"additional","affiliation":[{"name":"University of Texas M.D. Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theng W.","family":"Foong","sequence":"additional","affiliation":[{"name":"National University Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi W.","family":"Tan","sequence":"additional","affiliation":[{"name":"National University Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea P. A.","family":"Yap","sequence":"additional","affiliation":[{"name":"National University Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet066"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/1687-7934.153946"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1992.tb03544.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318221fcc9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/TheIAForum.TheIAForum_34_17"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12025"},{"key":"e_1_2_9_8_1","article-title":"Visual analog scale vs. numerical rating scale: Much Ado About Nothing?","author":"Diane M.","year":"2003","journal-title":"NEJM Journal Watch"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199406000-00023"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2999(91)90046-S"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/aer.AER_54_18"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3126\/jnhrc.v16i1.19362"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199803000-00015"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"123","article-title":"Minimum appropriate dose of lidocaine with a fixed dose of sufentanil epinephrine used for spinal anesthesia in caesarian section","volume":"2","author":"Golfam P.","year":"2013","journal-title":"Anesthesiology and Pain Medicine"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.84841"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.11.062"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199904000-00023"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02614.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-011-1002-y"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9568.2008.06260.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2006.00919.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/aer.AER_227_17"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0265021507003079"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2002.02873.x"},{"issue":"11","key":"e_1_2_9_26_1","first-page":"581","article-title":"A randomised controlled trial to evaluate the effectiveness of intrathecal bupivacaine combined with different adjuvants (fentanyl, clonidine and dexmedetomidine) in caesarean section","volume":"65","author":"Li Z.","year":"2015","journal-title":"Drug Research (Stuttgart)"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060518797000"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000000403"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.119151"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes400"},{"key":"e_1_2_9_31_1","first-page":"A495","article-title":"Evaluation of effect of dexmedetomidine in reducing shivering following epidural anesthesia","volume":"101","author":"Maroof M.","year":"2004","journal-title":"Anesthesiology"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31822b8629"},{"key":"e_1_2_9_33_1","unstructured":"Mendeley. (2008).Desktop | Mendeley. Mendeley. Version 1.19.2."},{"issue":"4","key":"e_1_2_9_34_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.36076\/ppj.2012\/15\/339","article-title":"Efficacy of intrathecally administered dexmedetomidine versus dexmedetomidine with fentanyl in patients undergoing major abdominal cancer surgery","volume":"15","author":"Mohamed A. A.","year":"2012","journal-title":"Pain Physician"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1476"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2016\/1511"},{"issue":"4","key":"e_1_2_9_38_1","first-page":"9","article-title":"Optimal dose of intrathecal dexmedetomidine in lower abdominal surgeries in average Indian adult","volume":"10","author":"Naaz S.","year":"2016","journal-title":"Journal of Clinical Diagnostic Research"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.150549"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3181b87066"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.153040"},{"issue":"3","key":"e_1_2_9_42_1","first-page":"6","article-title":"Evaluation of dexmedetomidine as an adjuvant to intrathecal bupivacaine in infraumbilical surgeries","volume":"10","author":"Patro S. S.","year":"2016","journal-title":"Journal of Clinical Diagnostic Research"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011770.pub2"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0531-7"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2015\/52"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2015\/137"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0104-42302008000200011"},{"issue":"1","key":"e_1_2_9_48_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.36076\/ppj\/2015.18.71","article-title":"Comparison of the effects of adding dexmedetomidine versus midazolam to intrathecal bupivacaine on postoperative analgesia","volume":"18","author":"Samantaray A.","year":"2015","journal-title":"Pain Physician"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2999(91)90535-X"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.194537"},{"issue":"49","key":"e_1_2_9_51_1","first-page":"3255","article-title":"A comparative clinical study of intrathecal dexmedetomidine 5 mu g and intrathecal fentanyl 25 mu g as an adjuvant with 0.5% hyperbaric bupivacaine 12.5mg in elective lower limb surgeries","volume":"5","author":"Shashikala T. K.","year":"2016","journal-title":"Journal of Evolution of Medical and Dental Sciences"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(03)00309-4"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.4103\/aer.AER_62_17"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1304100110"},{"issue":"9","key":"e_1_2_9_55_1","first-page":"468","article-title":"Comparative evaluation of intrathecal bupivacaine dexmedetomidine in caesarean section","volume":"65","author":"Sun Y.","year":"2015","journal-title":"Drug Research (Stuttgart)"},{"issue":"3","key":"e_1_2_9_56_1","first-page":"348","article-title":"Effect of adding intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine for elective cesarean section","volume":"22","author":"Sushruth M. R.","year":"2018","journal-title":"Anaesthesia, Pain and Intensive Care"},{"issue":"2","key":"e_1_2_9_57_1","first-page":"147","article-title":"Comparison of dexmedetomidine and Clonidine as an adjuvant to intrathecal bupivacaine in lower limb surgery: A randomised, double\u2010blind, placebo controlled trial","volume":"19","author":"Suthar O.","year":"2015","journal-title":"Anaesthesia, Pain and Intensive Care"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00068.x"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-015-0145-1"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093114"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2016.57.4.998"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/956825"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.666"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183154"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060517707113"},{"issue":"10","key":"e_1_2_9_66_1","first-page":"18860","article-title":"The effect of different doses of intrathecal dexmedetomidine on spinal anesthesia: A meta analysis","volume":"9","author":"Zhang Y.","year":"2016","journal-title":"International Journal of Clinical and Experimental Medicine"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejp.1575","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T09:56:17Z","timestamp":1693734977000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.1575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,22]]},"references-count":65,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1002\/ejp.1575"],"URL":"https:\/\/doi.org\/10.1002\/ejp.1575","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,22]]},"assertion":[{"value":"2020-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}