Non-opioid analgesics as adjuvants to opioid for pain management in adult patients in the ICU: A systematic review and meta-analysis.
PURPOSE
To identify the impact of non-opioid analgesics as adjuvants to opioid on opioid consumption and its side effects, as well as the analgesic effectiveness in adult patients in the ICU.


METHODS
Only randomized clinical trials using non-opioid analgesics for analgesia in the ICU were included. Pooled analyses with 95% CI were determined.


RESULTS
Twelve studies (mainly surgical and Guillain-Barre syndrome patients) were included. Non-opioid analgesics as adjuvants to opioid were associated with a significant reduction in the consumption of opioids when compared with opioid use alone at Day 1 (MD -15.40; 95% CI -22.41 to -8.39; P < .001) and Day 2 (MD -22.93; 95% CI -27.70 to -18.16; P < .001). Non-opioid analgesics as adjuvants to opioid were associated with a significantly lower incidence of nausea and vomiting when compared with opioid use alone (RR 0.46; 95% CI 0.30 to 0.68; P < .001). Non-opioid analgesics as adjuvants to opioid significantly decreased the pain score at Day 1 (MD -0.68; 95% CI -1.28 to -0.08; P = .03) and Day 2 (MD -1.36; 95% CI -2.47 to -0.24; P = .02).


CONCLUSIONS
Non-opioid analgesics as adjuvants to opioid reduced the consumption and the side effects of opioids in adult surgical and Guillain-Barre syndrome patients in the ICU.


TRIAL REVIEW REGISTRATION
PROSPERO international prospective register of systematic reviews on January 23, 2017, registration number CRD42017055768.
['Zhao|Huiying|H|', 'Yang|Shuguang|S|', 'Wang|Huixia|H|', 'Zhang|Hua|H|', 'An|Youzhong|Y|']
D000328:Adult D000698:Analgesia D018712:Analgesics, Non-Narcotic D000701:Analgesics, Opioid D017024:Chemotherapy, Adjuvant D006801:Humans D007362:Intensive Care Units D009325:Nausea D059408:Pain Management D014839:Vomiting
Non-opioid analgesic Adjuvants Opioid Analgesia Intensive care unit