Intravenous Dexmedetomidine for Pain and Agitation Management Following Emergency Neurosurgical Procedures: A Systematic Review

Introduction: Postoperative pain and agitation are common complications following emergency neurosurgical procedures and may adversely impact neurological recovery. Dexmedetomidine, a selective α۲-adrenergic agonist, has emerged as a promising agent due to its analgesic, sedative, and opioid-sparing properties with minimal respiratory depression.Materials and Methods: This systematic review was conducted following PRISMA guidelines. A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was performed through December ۲۰۲۴. Studies evaluating intravenous dexmedetomidine for postoperative pain and agitation management in adult emergency neurosurgical patients were included. Data extraction focused on analgesic efficacy, sedation quality, adverse effects, and ICU-related outcomes.Results: Three eligible studies with sample sizes ranging from ۳۵ to ۶۰ patients were included. Dexmedetomidine was associated with reduced postoperative pain scores (VAS <۳.۱۰), lower incidence of agitation (۱۲.۰۰%–۲۱.۵۰%), decreased opioid use (۱۶.۸۹–۲۲.۳۴ mg morphine equivalents), and shorter mechanical ventilation durations. Hemodynamic side effects, including hypotension and bradycardia, were infrequent and manageable.Conclusion: Intravenous dexmedetomidine appears to be a safe and effective option for managing pain and agitation following emergency neurosurgery. Larger trials are needed to confirm these findings and establish standardized protocols.

کلیدواژه ها:

dexmedetomidine ، Emergency Neurosurgery ، Postoperative Agitation ، Pain management