Intravenous dexmedetomidine and its effects on remifentanil-induced hyperalgesia and opioid consumption: A systematic review and meta-analysis of randomized controlled trials
Pooled result · Time to first rescue analgesiaResult — go to the resultMD 46.08 min 95% CI 30.52–61.65Authors' conclusion
Dexmedetomidine may mitigate RIH and, indirectly, aspects of AOT as suggested through surrogate outcomes such as opioid consumption and pain scores.
Study context
- Population
- Adult surgical patients receiving remifentanil, perioperative setting
- Participants
- 803 patients · 13 randomized controlled trials (RCTs)
- Comparison
- IV dexmedetomidine vs control
- Outcome
- Time to first rescue analgesia
Pooled result
As reported in the abstract
MD
46.08 min
95% CI 30.52–61.65
P < 0.00001
IV dexmedetomidine vs control
MD 46.08 min (95% CI 30.52–61.65); P < 0.00001
Further pooled results
Opioid consumption · postoperative anesthesia care unit (PACU) and 24 h postoperatively
- Reduced with dexmedetomidine
Pain scores · PACU and up to 24 h
- Significantly lower with dexmedetomidine
Primary hyperalgesia
- Moderate protective effect of dexmedetomidine
Safety
Intraoperative bradycardia
- Greater incidence with dexmedetomidine
Original publication
Intravenous dexmedetomidine and its effects on remifentanil-induced hyperalgesia and opioid consumption: A systematic review and meta-analysis of randomized controlled trials. J Clin Anesth. Published 30 January 2026. doi:10.
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