A meta-analysis of analgesic and sedative effects of dexmedetomidine in burn patients

Sedation for burn patients is provided by a variety of techniques determined usually by institutional preferences. The available pool of drugs has recently expanded to include dexmedetomidine (DEX), a α2-adrenergic receptor agonist with analgesic and sedative potential. Beneficial effects of DEX in burn patients have been described in many studies published over the last 5 years. The aim of this study is to perform a systematic review and meta-analysis of the available literature to determine the role of DEX for analgosedation of burn patients. We searched any article that matched the keywords "dexmedetomidine" and "burn", published before October 01, 2012. The methodological quality of studies was assessed using the recommendation of the Oxford Centre for Evidence Based Medicine (OCEBM). Our search yielded eleven total citations, of which four studies (266 patients) met the inclusion criteria of DEX for analgosedation in burn patients. There are no meta-analyses published that met our inclusion criteria. Even though there were only a small number of clinical trials available, the meta-analysis shows evidence for deeper and better sedation as well as for prevention of hypertension when using DEX as an adjunct during burn procedures. No evidence was found for reduced pain scores in this setting. The authors recommend the development of a prospective, randomized, controlled multicenter trial with an adequate number of patients to further elucidate the potentially beneficial effects of DEX for the management of burn patients.