{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T12:39:23Z","timestamp":1778330363920,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:00:00Z","timestamp":1639180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Craniotomy involves procedures with high incidences of postoperative pain. Dexmedetomidine, a highly selective a2-adrenoreceptor agonist, has been shown to be beneficial in neuroanaesthesia. The purpose of this narrative review was to assess the effect and safety of dexmedetomidine given intraoperatively during anaesthesia compared to placebo and demonstrate the effect on acute postoperative pain in adult patients undergoing craniotomy. Literature published from 1996 until 2021 were analysed through a search of PubMed, Medline and Embase. Randomised controlled trials investigating intraoperative administration of Dexmedetomidine with evaluation of postoperative pain were included. Medical Subject Headings terms and free-text words were used to identify articles related to the intraoperative use of Dexmedetomidine and postcraniotomy pain. Thirteen distinct randomized controlled trials with 882 recruited patients undergoing craniotomy were identified as eligible for final inclusion. Intraoperative administration of dexmedetomidine is associated with decreased postoperative pain and opioid consumption, and it assures haemodynamic stability. Dexmedetomidine is an efficacious adjunct in craniotomy in adults, showing benefits in reduction of postoperative pain and analgesic consumption. Dexmedetomidine also offers haemodynamic stability. However, widespread methodological heterogeneity of the papers prohibits a valid meta-analysis.<\/jats:p>","DOI":"10.3390\/brainsci11121636","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T01:28:11Z","timestamp":1639358891000},"page":"1636","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Nesjla Sofia","family":"Syrous","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terje","family":"Sundstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway"},{"name":"Department of Neurosurgery, Haukeland University Hospital, 5021 Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eirik","family":"S\u00f8fteland","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway"},{"name":"Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6759-3929","authenticated-orcid":false,"given":"Ib","family":"Jammer","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway"},{"name":"Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/ACO.0b013e32833e15b9","article-title":"Acute and chronic pain following craniotomy","volume":"23","author":"Flexman","year":"2010","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e13338","DOI":"10.1111\/ijcp.13338","article-title":"Comparison of intraoperative fentanyl with dexmedetomidine for perioperative analgesia and opioid consumption during craniotomies: A randomised controlled pilot study with non-inferiority design","volume":"73","author":"Sriganesh","year":"2019","journal-title":"Int. J. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1046\/j.1526-4610.1999.3902089.x","article-title":"Headache after resection of acoustic neuroma","volume":"39","author":"Mosek","year":"1999","journal-title":"Headache"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.4103\/sni.sni_301_17","article-title":"Designing a pain management protocol for craniotomy: A narrative review and consideration of promising practices","volume":"8","author":"Vacas","year":"2017","journal-title":"Surg. Neurol. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/ANA.0b013e3181df0600","article-title":"Prospective assessment of postoperative pain after craniotomy","volume":"22","author":"Mordhorst","year":"2010","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3171\/jns.2007.106.2.210","article-title":"Prospective evaluation of pain and analgesic use following major elective intracranial surgery","volume":"106","author":"Gottschalk","year":"2007","journal-title":"J. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.clinthera.2015.02.011","article-title":"Effect of Intraoperative Dexmedetomidine on Post-Craniotomy Pain","volume":"37","author":"Peng","year":"2015","journal-title":"Clin. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/j.1365-2044.2005.03997.x","article-title":"Acute and chronic pain following craniotomy: A review","volume":"60","author":"Matta","year":"2005","journal-title":"Anaesthesia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/00000542-200007000-00012","article-title":"Relation between Perioperative Hypertension and Intracranial Hemorrhage after Craniotomy","volume":"93","author":"Basali","year":"2000","journal-title":"Anesthesiology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/ANA.0b013e3182a2166f","article-title":"Comparing the effects of oral clonidine premedication with intraoperative dexmedetomidine infusion on anesthetic requirement and recovery from anesthesia in patients undergoing major spine surgery","volume":"26","author":"Mariappan","year":"2014","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1046\/j.1365-2044.1999.01114.x","article-title":"Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit","volume":"54","author":"Venn","year":"1999","journal-title":"Anaesthesia"},{"key":"ref_12","first-page":"1","article-title":"Dexmedetomidine for neurological surgery","volume":"57","author":"Bekker","year":"2005","journal-title":"Neurosurgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/0885066602239122","article-title":"The role of the alpha2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit","volume":"18","author":"Martin","year":"2003","journal-title":"J. Intensive Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/00000539-200003000-00035","article-title":"Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions","volume":"90","author":"Hall","year":"2000","journal-title":"Anesth. Analg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"475","DOI":"10.4103\/2141-9248.122044","article-title":"Dexmedetomidine: An adjuvant making large inroads into clinical practice","volume":"3","author":"Bajwa","year":"2013","journal-title":"Ann. Med. Health Sci. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1213\/ane.0b013e3181804298","article-title":"The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy","volume":"107","author":"Bekker","year":"2008","journal-title":"Anesth. Analg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/ANA.0000000000000221","article-title":"The Effects of Dexmedetomidine and Remifentanil on Hemodynamic Stability and Analgesic Requirement After Craniotomy: A Randomized Controlled Trial","volume":"28","author":"Rajan","year":"2016","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/ANA.0000000000000190","article-title":"The Opioid-sparing Effect of Intraoperative Dexmedetomidine Infusion After Craniotomy","volume":"28","author":"Song","year":"2016","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_19","first-page":"63","article-title":"Remifentanil-propofol vs dexmedetomidine-propofol--anesthesia for supratentorial craniotomy","volume":"20","author":"Turgut","year":"2009","journal-title":"Middle East J. Anesthesiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/ANA.0000000000000283","article-title":"Effects of an Intraoperative Dexmedetomidine Bolus on the Postoperative Blood Pressure and Pain Subsequent to Craniotomy for Supratentorial Tumors","volume":"29","author":"Yun","year":"2017","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1093\/bja\/aew024","article-title":"Dexmedetomidine vs propofol-remifentanil conscious sedation for awake craniotomy: A prospective randomized controlled trial","volume":"116","author":"Goettel","year":"2016","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1093\/bja\/ael220","article-title":"Dexmedetomidine as an anaesthetic adjuvant in patients undergoing intracranial tumour surgery: A double-blind, randomized and placebo-controlled study","volume":"97","author":"Tanskanen","year":"2006","journal-title":"Br. J. Anaesth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/01.wnq.0000163345.17549.07","article-title":"Dexmedetomidine-Remifentanil or Propofol-Remifentanil Anesthesia in Patients Undergoing Intracranial Surgery","volume":"15","author":"Isik","year":"2005","journal-title":"Neurosurg. Q."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"980","DOI":"10.3349\/ymj.2016.57.4.980","article-title":"Comparison of Dexmedetomidine and Remifentanil on Airway Reflex and Hemodynamic Changes during Recovery after Craniotomy","volume":"57","author":"Kim","year":"2016","journal-title":"Yonsei Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1016\/j.sjbs.2020.03.027","article-title":"Brain protective effect and hemodynamics of dexmedetomidine hydrochloride in patients with intracranial aneurysm","volume":"27","author":"Zheng","year":"2020","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1055\/s-0040-1703968","article-title":"Effect of Low-Dose Dexmedetomidine on the Anesthetic and Recovery Profile of Sevoflurane-Based Anesthesia in Patients Presenting for Supratentorial Neurosurgeries: A Randomized Double-Blind Placebo-Controlled Trial","volume":"11","author":"Prathapadas","year":"2020","journal-title":"J. Neurosci. Rural. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/ANA.0000000000000403","article-title":"Dexmedetomidine Reduces Perioperative Opioid Consumption and Postoperative Pain Intensity in Neurosurgery: A Meta-analysis","volume":"30","author":"Liu","year":"2018","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1213\/01.ANE.0000093225.39866.75","article-title":"The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery","volume":"98","author":"Arain","year":"2004","journal-title":"Anesth. Analg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/gps.5406","article-title":"Intraoperative dexmedetomidine for prevention of postoperative delirium in elderly patients with mild cognitive impairment","volume":"36","author":"Xin","year":"2021","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/CNQ.0000000000000289","article-title":"Dexmedetomidine\u2019s Relationship to Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review","volume":"43","author":"Halpin","year":"2020","journal-title":"Crit. Care Nurs. Q."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"549516","DOI":"10.3389\/fnins.2020.549516","article-title":"The Effect and Optimal Dosage of Dexmedetomidine Plus Sufentanil for Postoperative Analgesia in Elderly Patients With Postoperative Delirium and Early Postoperative Cognitive Dysfunction: A Single-Center, Prospective, Randomized, Double-Blind, Controlled Trial","volume":"14","author":"Zhao","year":"2020","journal-title":"Front. Neurosci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/00000542-200008000-00019","article-title":"Acute opioid tolerance: Intraoperative remifentanil increases postoperative pain and morphine requirement","volume":"93","author":"Guignard","year":"2000","journal-title":"Anesthesiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/ANA.0000000000000144","article-title":"Dexmedetomidine as an Anesthetic Adjuvant in Patients Undergoing Transsphenoidal Resection of Pituitary Tumor","volume":"27","author":"Gopalakrishna","year":"2015","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/08998280.2001.11927725","article-title":"Dexmedetomidine: A novel sedative-analgesic agent","volume":"14","author":"Gertler","year":"2001","journal-title":"Bayl. Univ. Med Cent. Proc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s13054-015-0787-y","article-title":"Dexmedetomidine versus standard care sedation with propofol or midazolam in intensive care: An economic evaluation","volume":"19","author":"Turunen","year":"2015","journal-title":"Crit. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/CCM.0b013e3181bc81c9","article-title":"A cost-minimization analysis of dexmedetomidine compared with midazolam for long-term sedation in the intensive care unit","volume":"38","author":"Dasta","year":"2010","journal-title":"Crit. Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1007\/s12630-015-0444-6","article-title":"The real cost of care: Focus on value for money, rather than price-tags","volume":"62","author":"Martin","year":"2015","journal-title":"Can. J. Anaesth."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1111\/aas.13452","article-title":"Dexmedetomidine vs propofol as sedation for implantation of neurostimulators: A single-center single-blinded randomized controlled trial","volume":"63","author":"Ceuppens","year":"2019","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/aas.13579","article-title":"Cost analysis of dexmedetomidine versus propofol during the implantation of a neurostimulator","volume":"64","author":"Stronks","year":"2020","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/aas.13852","article-title":"Is clinical heterogeneity the foremost prominent threat to the validity of meta-analyses?","volume":"65","author":"Fabritius","year":"2021","journal-title":"Acta Anaesthesiol. Scand."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/11\/12\/1636\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:45:35Z","timestamp":1760168735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/11\/12\/1636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,11]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["brainsci11121636"],"URL":"https:\/\/doi.org\/10.3390\/brainsci11121636","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,11]]}}}