Abstract: Objective To evaluate the efficacy and safety of dexmedetomidine combined with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA). Methods The randomized controlled trials of dexmedetomidine combined with sufentanil for PCIA were gathered from PubMed, Embase, Cochrane library, CNKI and VIP Data. After data extraction and quality assessment of the included RCTs, the RevMan 5.3 software was applied for Meta-analysis of visual analog scale (VAS) score, Ramsay score (RSS), number of bolus applications of PCIA and safety. Results The results of Meta-analyses showed that: ① as for VAS score, compared with the sufentanil group, the combination group had significant differences (P <0.05) at 12, 24 and 48 h post-operation; ②as for Ramsay sedation score, compared with the sufentanil group, the RSS at 12, 24, and 48-hour had significant differences when sufentanil combined with ketamine (WMD=0.68, 95% CI 0.35 to 1.01; WMD=0.56, 95% CI 0.27 to 0.85, WMD=0.44 95% CI 0.11 to 0.76, P<0.05); ③there were significant differences in number of bolus applications of PCIA at 24 and 48 h post-operation between the combined group and the single sufentanil group (WMD=-2.64, 95%CI -4.50 to -0.78; WMD=-1.49, 95%CI -6.13 to 3.14, P<0.01); ④as for adverse reaction in the combination group compared with the single sufentanil group, incidences of nausea and vomiting, itchy skin, bradycardia and total adverse reaction were significantly (P<0.01, P=0.003, P=0.03 and P<0.01) decreased. Conclusion According to the domestic evidence, dexmedetomidine combined with sufentanil for PCIA could effectively alleviate post-operative pain compared with sufentanil alone, and can be able to reduce the incidences of adverse reactions.

Key words: dexmedetomidine, sufentanil, postoperative patient-controlled intravenous analgesia, Meta-analysis, systematic review