Effects of dexmedetomidine use on elderly patient’s renal function submitted to laparoscopic surgery: systematic review

Introduction Postoperative acute renal failure is a common complication found in patients after laparoscopic surgery. This study aims to systematically review the literature to check the effect of dexmedetomidine on acute renal failure. Methods A systematic review was carried out, including abstracts published from Jan 2016 to August 2024, where the population of interest was patients aged 60 years or older undergoing laparoscopic surgery. The intervention of interest was dexmedetomidine individually or as an anesthetic adjuvant used in the perioperative period at any dose. The comparison of interest was placebo or any perioperative medication used for the same purpose. Acute renal failure, urinary output, and length of stay (LOS) were the outcomes of interest. The studies of interest were clinical trials. Remote database searches were performed at PubMed, SCOPUS, Web of Science, Embase, and Cochrane, as well as full manuscript bibliographies. The risk of bias was assessed with Cochrane’s RoB2 and results confidence was assessed with GRADE. Results 13 studies were analyzed. A consistent but not significant nephroprotective effect of dexmedetomidine was observed. A neutral effect was observed in urinary output and LOS, and there is evidence of reporting bias for LOS. The confidence in these findings is either poor or moderate. Conclusion The use of DEX in the elderly population undergoing laparoscopy surgeries did not reduce the LOS or urinary output, but there is moderate confidence that it has a potential nephroprotective effect.