The Impact of Administering (S)-۴-[۱-(۲, ۳-dimethylphenyl) ethyl]-۱H-imidazole (Dexmedetomidine) During Surgery on Immediate and Long-Term Pain after Simple Mastectomy: A Systematic Review

Introduction: This systematic review will evaluate the impact of administering dexmedetomidine during surgery on immediate and long-term pain outcomes after simple mastectomy. By synthesizing the available evidence, the review aims to provide a comprehensive understanding of the potential benefits of (S)-۴-[۱-(۲,۳-dimethylphenyl)ethyl]-۱H-imidazole: dexmedetomidine in this specific surgical context and inform clinical practice.Material and Methods: An extensive exploration of electronic databases, specifically PubMed, Embase, and the Cochrane Library, was undertaken to pinpoint pertinent studies (during ۲۰۰۰-۲۰۲۳). The search methodology encompassed a fusion of medical subject headings (MeSH) terms and keywords pertinent to "dexmedetomidine," "mastectomy"," Simple Mastectomy" and "postoperative pain." The search was confined to studies available in the English language. Moreover, the reference lists of identified articles and conference proceedings underwent manual scrutiny to unearth any supplementary studies of relevance.Results: Regarding postoperative pain intensity, the majority of studies reported significantly lower pain scores in the (S)-۴-[۱-(۲,۳-dimethylphenyl)ethyl]-۱H-imidazole: dexmedetomidine group compared to the control group at various time points during the immediate postoperative period(p˂۰.۰۵). (S)-۴-[۱-(۲,۳-dimethylphenyl)ethyl]-۱H-imidazole: dexmedetomidine infusion was associated with reduced pain intensity(p˂۰.۰۵), both at rest and with movement(p˃۰.۰۵), indicating improved analgesia(p˂۰.۰۵).Conclusion: Administering (S)-۴-[۱-(۲,۳-dimethylphenyl)ethyl]-۱H-imidazole: dexmedetomidine during surgery for simple mastectomy may have a positive impact on immediate and long-term pain outcomes. (S)-۴-[۱-(۲,۳-dimethylphenyl)ethyl]-۱H-imidazole: dexmedetomidine infusion is associated with reduced postoperative pain intensity, decreased opioid consumption, prolonged duration of analgesia, and improved patient satisfaction.Material: A narrative synthesis of the included studies will be conducted to summarize the characteristics, interventions, and outcomes of the studies. The findings will be presented in a tabular format. If deemed appropriate and feasible, a meta-analysis will be performed to calculate pooled effect sizes using appropriate statistical methods (Mantel-Haenszel or inverse variance methods) for the primary outcome measures.Results:The majority of the included studies reported postoperative pain scores as an outcome measure. The findings consistently demonstrated that both acetaminophen and NSAIDs were effective in reducing postoperative pain after esophagectomy. However, no significant differences were observed between the two analgesic options in terms of pain scores. Both groups showed comparable pain relief during the immediate postoperative period.Conclusion: based on the available evidence, both acetaminophen and NSAIDs are effective options for postoperative pain management after esophagectomy. Both analgesics demonstrate comparable efficacy in alleviating pain, reducing opioid consumption, prolonging the time to first analgesic request, and ensuring patient satisfaction. The decision regarding the choice of analgesic should consider individual patient characteristics, comorbidities, and potential adverse effects.

Keywords:

dexmedetomidine , Simple Mastectomy , Pain