PDF(Pubmed)
Abstract：
Dexmedetomidine is a promising pharmaceutical strategy to minimise opioid use during surgery. Despite its growing use, it is uncertain whether dexmedetomidine can improve patient-centred outcomes such as quality of recovery and pain.
We will conduct a systematic review and meta-analysis following the recommendations of the Cochrane Handbook for Systematic Reviews. We will search MEDLINE, Embase, CENTRAL, Web of Science and CINAHL approximately in October 2023. We will include randomised controlled trials evaluating the impact of systemic intraoperative dexmedetomidine on patient-centred outcomes. Patient-centred outcome definition will be based on the consensus definition established by the Standardised Endpoints in Perioperative Medicine initiative (StEP-COMPAC). Our primary outcome will be the quality of recovery after surgery. Our secondary outcomes will be patient well-being, function, health-related quality of life, life impact, multidimensional assessment of postoperative acute pain, chronic pain, persistent postoperative opioid use, opioid-related adverse events, hospital length of stay and adverse events. Two reviewers will independently screen and identify trials and extract data. We will evaluate the risk of bias of trials using the Cochrane Risk of Bias Tool (RoB 2.0). We will synthesise data using a random effects Bayesian model framework, estimating the probability of achieving a benefit and its clinical significance. We will assess statistical heterogeneity with the tau-squared and explore sources of heterogeneity with meta-regression. We have involved patient partners, clinicians, methodologists, and key partner organisations in the development of this protocol, and we plan to continue this collaboration throughout all phases of this systematic review.
Our systematic review does not require research ethics approval. It will help inform current clinical practice guidelines and guide development of future randomised controlled trials. The results will be disseminated in open-access peer-reviewed journals, presented at conferences and shared among collaborators and networks.
CRD42023439896.
We will conduct a systematic review and meta-analysis following the recommendations of the Cochrane Handbook for Systematic Reviews. We will search MEDLINE, Embase, CENTRAL, Web of Science and CINAHL approximately in October 2023. We will include randomised controlled trials evaluating the impact of systemic intraoperative dexmedetomidine on patient-centred outcomes. Patient-centred outcome definition will be based on the consensus definition established by the Standardised Endpoints in Perioperative Medicine initiative (StEP-COMPAC). Our primary outcome will be the quality of recovery after surgery. Our secondary outcomes will be patient well-being, function, health-related quality of life, life impact, multidimensional assessment of postoperative acute pain, chronic pain, persistent postoperative opioid use, opioid-related adverse events, hospital length of stay and adverse events. Two reviewers will independently screen and identify trials and extract data. We will evaluate the risk of bias of trials using the Cochrane Risk of Bias Tool (RoB 2.0). We will synthesise data using a random effects Bayesian model framework, estimating the probability of achieving a benefit and its clinical significance. We will assess statistical heterogeneity with the tau-squared and explore sources of heterogeneity with meta-regression. We have involved patient partners, clinicians, methodologists, and key partner organisations in the development of this protocol, and we plan to continue this collaboration throughout all phases of this systematic review.
Our systematic review does not require research ethics approval. It will help inform current clinical practice guidelines and guide development of future randomised controlled trials. The results will be disseminated in open-access peer-reviewed journals, presented at conferences and shared among collaborators and networks.
CRD42023439896.
摘要：
背景：右美托咪定是减少手术过程中阿片类药物使用的一种有前景的药物策略。尽管它的使用越来越多，目前尚不确定右美托咪定是否能改善以患者为中心的结局,如恢复质量和疼痛.
方法：我们将根据《Cochrane系统评价手册》的建议进行系统评价和荟萃分析。我们将搜索MEDLINE,Embase,中部,WebofScience和CINAHL大约在2023年10月。我们将包括随机对照试验，评估全身术中右美托咪定对以患者为中心的结果的影响。以患者为中心的结果定义将基于围手术期医学标准化终点计划（StEP-COMPAC）建立的共识定义。我们的主要结果将是手术后的恢复质量。我们的次要结果将是患者的幸福感，函数,与健康相关的生活质量，生活影响,术后急性疼痛的多维评估，慢性疼痛,术后持续使用阿片类药物，阿片类药物相关的不良事件，住院时间和不良事件。两名评审员将独立筛选和识别试验并提取数据。我们将使用Cochrane偏差风险工具（RoB2.0）评估试验的偏差风险。我们将使用随机效应贝叶斯模型框架来综合数据，估计获得益处的概率及其临床意义。我们将使用tau平方评估统计异质性，并使用meta回归探索异质性的来源。我们有耐心的伙伴，临床医生,方法学家,以及制定该协议的关键合作伙伴组织，我们计划在系统审查的所有阶段继续这种合作。
背景：我们的系统评价不需要研究伦理批准。它将有助于为当前的临床实践指南提供信息，并指导未来随机对照试验的发展。结果将在开放获取的同行评审期刊上传播，在会议上提出，并在合作者和网络之间分享。
■CRD42023439896。
方法：我们将根据《Cochrane系统评价手册》的建议进行系统评价和荟萃分析。我们将搜索MEDLINE,Embase,中部,WebofScience和CINAHL大约在2023年10月。我们将包括随机对照试验，评估全身术中右美托咪定对以患者为中心的结果的影响。以患者为中心的结果定义将基于围手术期医学标准化终点计划（StEP-COMPAC）建立的共识定义。我们的主要结果将是手术后的恢复质量。我们的次要结果将是患者的幸福感，函数,与健康相关的生活质量，生活影响,术后急性疼痛的多维评估，慢性疼痛,术后持续使用阿片类药物，阿片类药物相关的不良事件，住院时间和不良事件。两名评审员将独立筛选和识别试验并提取数据。我们将使用Cochrane偏差风险工具（RoB2.0）评估试验的偏差风险。我们将使用随机效应贝叶斯模型框架来综合数据，估计获得益处的概率及其临床意义。我们将使用tau平方评估统计异质性，并使用meta回归探索异质性的来源。我们有耐心的伙伴，临床医生,方法学家,以及制定该协议的关键合作伙伴组织，我们计划在系统审查的所有阶段继续这种合作。
背景：我们的系统评价不需要研究伦理批准。它将有助于为当前的临床实践指南提供信息，并指导未来随机对照试验的发展。结果将在开放获取的同行评审期刊上传播，在会议上提出，并在合作者和网络之间分享。
■CRD42023439896。
