Date of this Version

12-9-2021

Document Type

DNP Project

Abstract

Background: Opioid consumption is at an alarming rate in the United States. Their side effects have attracted debates on whether they are indispensable and continuously prompt further consideration of alternative approaches. Recent studies have suggested that dexmedetomidine has a good analgesic profile and can reduce opioid consumption. Additional studies are warranted to establish whether dexmedetomidine as an adjunct therapy can influence opioid consumption in surgical units.

Objectives: This literature review aimed to evaluate the current randomized controlled trials (RCTs) on the impact of dexmedetomidine as adjunct therapy on opioid consumption and further recommend best available practices on the current issue.

Methodology: Seven randomized control trials (RCTs) were evaluated in this systematic review. The RCTs found a statistically significant decrease in opioid consumption with the application of dexmedetomidine in patients receiving spinal anesthesia. With this information, a pre-test, educational module, and post-test were created for anesthesia providers to evaluate both baseline knowledge and knowledge growth.

Results: The evidence search and screening resulted in 7 RCTs. Three studies demonstrated dexmedetomidine infused at the induction of anesthesia to reduce post-operative and perioperative opioid consumption. Four studies demonstrated dexmedetomidine to reduce cumulative opioid consumption when administered before induction of anesthesia. One study demonstrated intranasal dexmedetomidine to impact cumulative opioid consumption.

Conclusion: Evidence shows that dexmedetomidine as adjunct therapy reduces opioid consumption preoperatively and post-operatively. The least effective dose is 0.5 μg/kg-1 μg/kg, and can be infused before or at the induction of anesthesia.

Keywords: Dexmedetomidine, opioids, spinal anesthesia, opioids consumption, surgical units, surgery, postoperative, perioperative.

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