Journal Information
Vol. 48. Issue 12.
Pages 693-703 (December 2024)
Share
Share
Download PDF
More article options
Visits
4
Vol. 48. Issue 12.
Pages 693-703 (December 2024)
Original article
Implications of opioid-sparing medications in critically ill patients: A scoping review
Implicaciones de los medicamentos ahorradores de opioides en pacientes críticos: una revisión exploratoria
Visits
4
Gabriella Gambadoroa, Brian J. Koppb, Brian L. Erstadc,
Corresponding author
erstad@pharmacy.arizona.edu

Corresponding author.
a Critical Care Pharmacist, Banner – University Medical Center, 1625 N. Campbell Avenue, Tucson, AZ, 85719, USA
b Clinical Pharmacy Specialist, Surgical-Trauma ICU, Banner – University Medical Center, 1625 N. Campbell Avenue, Tucson, AZ, 85719, USA
c Department of Pharmacy Practice & Science, University of Arizona R. Ken Coit College of Pharmacy, Tucson, AZ, 85721, USA
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (1)
Table 1. Characteristics of Included Studies.
Additional material (1)
Abstract
Objective

The purpose of this scoping review was to evaluate literature involving opioid-sparing medications in critically ill patients with a focus on clinically meaningful outcomes.

Design

Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Setting

Intensive care unit.

Patients or participants

Adult patients in an intensive care unit setting.

Interventions

None.

Main variables of interest

PubMed and Cochrane Library were searched from October 1, 2019 to June 1, 2023. Inclusion criteria consisted of randomized controlled trials evaluating adjunctive analgesic use in adult patients in an intensive care unit setting.

Results

There were 343 citations and titles identified in the initial search, with 328 remaining after removal of duplicates, 294 excluded at title and abstract screening, 34 available for full text review, and six included in the scoping review. Most studies reported modest reductions in opioid use as a secondary endpoint. Improvement in clinical outcomes such as reduction in duration of mechanical ventilation or delirium were reported in two trials with dexmedetomidine.

Conclusions

In recently published trials of adjunctive agents in critically ill patients, opioid-sparing effects were small. Data to support improvements in clinical outcomes remains limited.

Keywords:
Opioid sparing
Critically ill
Pain control
Resumen
Objectivo

El propósito de esta revisión de alcance fue evaluar la literatura sobre medicamentos ahorradores de opioides en pacientes críticos con un enfoque en resultados clínicamente significativos.

Diseño

Revisión de alcance utilizando los elementos de informes preferidos para revisiones sistemáticas y la extensión de metanálisis para revisiones de alcance.

Ámbito

Unidad de Cuidados Intensivos.

Pacientes o participantes

Pacientes adultos en una unidad de cuidados intensivos.

Intervenciones

Ninguno.

Variables de interés principales

Se realizaron búsquedas en PubMed y Cochrane Library desde el 1 de octubre de 2019 hasta el 1 de junio de 2023. Los criterios de inclusión consistieron en ensayos controlados aleatorios que evaluaron el uso de analgésicos complementarios en pacientes adultos en una unidad de cuidados intensivos.

Resultados

Se identificaron 343 citas y títulos en la búsqueda inicial, 328 restantes después de la eliminación de duplicados, 294 excluidas en la selección de títulos y resúmenes, 34 disponibles para revisión del texto completo y seis incluidas en la revisión de alcance. La mayoría de los estudios informaron reducciones modestas en el uso de opioides como criterio de valoración secundario. En dos ensayos con dexmedetomidina se informaron mejoras en los resultados clínicos, como la reducción de la duración de la ventilación mecánica o el delirio.

Conclusiones

En ensayos publicados recientemente sobre agentes complementarios en pacientes críticamente enfermos, los efectos ahorradores de opioides fueron pequeños. Los datos que respaldan las mejoras en los resultados clínicos siguen siendo limitados.

Palabras clave:
Ahorro de opioides
Críticamente enfermo
Control de dolor

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?