Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol
Introduction 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.Methods and analysis We will conduct a systematic revi...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/2/e080012.full |
| _version_ | 1827324535859314688 |
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| author | Brian Hutton Dean A Fergusson Manoj M Lalu Daniel I McIsaac Guillaume Martel Alexis F Turgeon Husein Moloo Mélanie Bérubé Ian Gilron Patricia Poulin Stuart Nicholls Jason McVicar Maxime Le Michael Verret Fiona Zivkovic Megan Graham Allison Geist Helena Daudt John Bao Phuc Le |
| author_facet | Brian Hutton Dean A Fergusson Manoj M Lalu Daniel I McIsaac Guillaume Martel Alexis F Turgeon Husein Moloo Mélanie Bérubé Ian Gilron Patricia Poulin Stuart Nicholls Jason McVicar Maxime Le Michael Verret Fiona Zivkovic Megan Graham Allison Geist Helena Daudt John Bao Phuc Le |
| author_sort | Brian Hutton |
| collection | DOAJ |
| description | Introduction 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.Methods and analysis 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.Ethics and dissemination 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.PROSPERO registration number CRD42023439896. |
| first_indexed | 2024-03-08T08:15:32Z |
| format | Article |
| id | doaj.art-875156ee7f724004a8004077ca33d8e7 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-25T02:15:04Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-875156ee7f724004a8004077ca33d8e72024-03-07T10:25:08ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-080012Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocolBrian Hutton0Dean A Fergusson1Manoj M Lalu2Daniel I McIsaac3Guillaume Martel4Alexis F Turgeon5Husein Moloo6Mélanie Bérubé7Ian Gilron8Patricia Poulin9Stuart Nicholls10Jason McVicar11Maxime Le12Michael Verret13Fiona Zivkovic14Megan Graham15Allison Geist16Helena Daudt17John Bao Phuc Le18School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, CanadaSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaDepartments of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Quebec, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaPopulation Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), CHU de Québec - Université Laval Research Center, Québec, Quebec, CanadaDepartment of Anesthesiology and Perioperative Medicine, Queen`s University, Kingston, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaPatient Partner, The Ottawa Hospital, Ottawa, Ontario, CanadaPopulation Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), CHU de Québec - Université Laval Research Center, Québec, Quebec, CanadaPatient Partner, The Ottawa Hospital, Ottawa, Ontario, CanadaPatient Partner, The Ottawa Hospital, Ottawa, Ontario, CanadaPatient Partner, The Ottawa Hospital, Ottawa, Ontario, CanadaPain Canada, Pain BC, Vancouver, Alberta, CanadaFaculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaIntroduction 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.Methods and analysis 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.Ethics and dissemination 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.PROSPERO registration number CRD42023439896.https://bmjopen.bmj.com/content/14/2/e080012.full |
| spellingShingle | Brian Hutton Dean A Fergusson Manoj M Lalu Daniel I McIsaac Guillaume Martel Alexis F Turgeon Husein Moloo Mélanie Bérubé Ian Gilron Patricia Poulin Stuart Nicholls Jason McVicar Maxime Le Michael Verret Fiona Zivkovic Megan Graham Allison Geist Helena Daudt John Bao Phuc Le Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol BMJ Open |
| title | Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol |
| title_full | Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol |
| title_fullStr | Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol |
| title_full_unstemmed | Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol |
| title_short | Effectiveness of dexmedetomidine during surgery under general anaesthesia on patient-centred outcomes: a systematic review and Bayesian meta-analysis protocol |
| title_sort | effectiveness of dexmedetomidine during surgery under general anaesthesia on patient centred outcomes a systematic review and bayesian meta analysis protocol |
| url | https://bmjopen.bmj.com/content/14/2/e080012.full |
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