- Patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA) who receive dexmedetomidine have significantly less pain.
- They also are less likely to develop postoperative delirium and postoperative nausea and vomiting (PONV) compared with those who receive saline, ropivacaine, bupivacaine, or propofol, with similar risks for hypotension.
- Among TKA patients, the use of dexmedetomidine is associated with a significantly higher risk for bradycardia.
Why this matters
- Despite its known efficacy, dexmedetomidine was associated in previous studies with increased risk for hypotension and bradycardia requiring atropine.
- Systematic review and meta-analysis of 14 randomized controlled trials (N=1220) on patients undergoing TKA/THA.
- Funding: The National Natural Science Foundation, China.
- Dexmedetomidine significantly decreased pain scores after 24 hours of surgery (weighted mean difference [WMD], −0.36; I2, 90.0%; P<.001>
- Dexmedetomidine vs control groups showed decreased:
- Postoperative delirium rates: relative risk (RR), 0.38 (I2=0.0%; P<.001>
- Risks for postoperative nausea and vomiting in patients undergoing TKA: RR, 0.34 (I2, 0.0%; P<.01>
- Studies not highly powered.
Coauthored with Chitra Ravi, MPharm