SynthesisInternational journal of surgery (London, England)2025
Efficacy of perioperative dexmedetomidine in postoperative pain and neurocognitive functions in orthopedic surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.
Synthesis in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- From neuroinflammation to neuroprotection: a bibliometric analysis of anesthesia-associated postoperative cognitive dysfunction to guide clinical research (2000-2024).Frontiers in medicine · 2026Pooled it
- The effect of dexmedetomidine on emergence agitation and pain in post-anesthesia recovery of patients undergoing upper limb elective orthopedic surgery: a double-blind randomized clinical trial.BMC anesthesiology · 2026Trial
- Effect of Dexmedetomidine on Postoperative Analgesia After Video-assisted Thoracoscopic Lobectomy Surgery.International journal of medical sciences · 2026Trial
- Induction with Ciprofol Decreases Propofol Requirement During Propofol-Remifentanil Total Intravenous Anesthesia Maintenance in Elderly Patients Undergoing Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Dexmedetomidine for improving postpartum sleep quality following cesarean section in women: a randomized controlled trial.Frontiers in medicine · 2026Trial
- Comparison of Remimazolam and Dexmedetomidine on Postoperative Delirium and Emergence Agitation in Elderly Patients Undergoing Thoracoscopic Surgery: A Randomized, Double-Blind, Non-Inferiority Trial.Drug design, development and therapy · 2025Trial
- Perioperative neurocognitive disorders in older patients: a narrative review of current knowledge in 2026.Perioperative medicine (London, England) · 2026Review
- [Effect of intraoperative dexmedetomidine on postoperative sleep disturbance in elderly surgical patients: a prospective multicenter cohort study].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2026Observational
- Comparison of the Effects of Intraoperative Dexmedetomidine and Fentanyl Infusion on Postoperative Agitation and Analgesia in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy: A Prospective Randomized Trial.Children (Basel, Switzerland) · 2026Article
- Observational
- Ferroptosis: an emerging key mechanism linking aging, surgical and anesthetic exposure to postoperative cognitive dysfunction.Frontiers in immunology · 2026Review
- Dexmedetomidine and Postoperative Gastrointestinal Recovery: A Critical Narrative Review of Direct Enteric and Opioid-Sparing Pathways.Drug design, development and therapy · 2026Review
- Glymphatic-meningeal lymphatic system imbalance: a peripheral-to-central inflammatory bridge in perioperative neurocognitive disorders.Frontiers in immunology · 2026Review
- Review
- Commentary on: "Efficacy of perioperative dexmedetomidine on postoperative pain and neurocognitive functions in orthopaedic surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials".International journal of surgery (London, England) · 2025Article
- Dexmedetomidine and the glymphatic system: a new perspective in managing postoperative cognitive dysfunction.Frontiers in pharmacology · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWith an estimated 2.1 million hip and knee replacements performed annually in developed countries, orthopedic surgeries can result in complications such as postoperative pain and cognitive dysfunctions. Dexmedetomidine shows potential for reducing pain and opioid use and improving cognitive outcomes, but its efficacy in orthopedic settings needs further evaluation.
methodsA comprehensive literature search was performed across electronic databases (e.g., PubMed) up to 1 June 2024 to identify relevant randomized controlled trials (RCTs) investigating the use of dexmedetomidine for orthopedic surgeries. The primary outcomes included visual analog scale (VAS), opioid consumption, incidence of postoperative cognitive dysfunction (POCD), and postoperative delirium (POD). Meta-analysis was conducted using RevMan 5.3 and Stata 16.0, with statistical significance set at P < 0.05. Sensitivity analyses, along with trial sequential analysis (TSA), were used to evaluate the robustness of the findings.
resultsThe meta-analysis included 59 RCTs with 7713 participants and demonstrated that dexmedetomidine significantly reduced postoperative VAS score (mean difference [MD] -0.50, P = 0.0003) and opioid consumption (MD -11.91, P < 0.0001) and decreased the incidence of POCD (risk ratio [RR] 0.59, P = 0.006) and POD (RR 0.49, P < 0.0001). Dexmedetomidine also prolonged motor (MD: 1.70, P < 0.0001) and sensory block durations (MD: 1.80, P < 0.0001) and delayed the time to first rescue analgesics (MD: 1.51, P < 0.0001). TSA and sensitivity analysis confirmed the robustness and reliability of the results, whereas meta-regression revealed no significant effect of variables on primary outcomes.
conclusionOur study demonstrates that intravenous dexmedetomidine significantly improved postoperative pain and neurocognitive functions in orthopedic surgery patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.