Dexmedetomidine combined with local anesthetics in thoracic paravertebral block
Autor: | Qing-xiang Mao, Zhen Wang, Liyong Chen, Tong-jiu Yang, Lijun Wang, Kai Wang |
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Rok vydání: | 2018 |
Předmět: |
anesthesia adjuvant
Analgesic law.invention Fentanyl 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law medicine Humans Pain Management 030212 general & internal medicine Anesthetics Local Dexmedetomidine Pain Measurement Randomized Controlled Trials as Topic Pain Postoperative business.industry dexmedetomidine General Medicine Perioperative Odds ratio Analgesics Non-Narcotic Brachial Plexus Block Confidence interval Anesthesia Tramadol business Systematic Review and Meta-Analysis paravertebral block Research Article medicine.drug |
Zdroj: | Medicine |
ISSN: | 1536-5964 0025-7974 |
Popis: | Background Dexmedetomidine (DEX) improves postoperative pain scores and prolongs the duration of blockage when combined with local anesthetics (LAs) for neuraxial and brachial plexus block; however, there is little information about the effectiveness of DEX as an adjuvant to LAs in paravertebral block (PVB). Therefore, a systematic review and meta-analysis were performed to evaluate the safety and efficacy of DEX combined with LAs in PVB. Method An electronic database search from inception date to February 2018 was performed. Randomized controlled trials (RCTs) comparing DEX as an adjuvant to LAs with LAs alone for PVB in adult patients were included. Postoperative pain scores, duration of analgesia, cumulative perioperative analgesic consumption, and adverse events were analyzed. Result We identified 7 trials enrolling 350 patients and found that DEX reduced pain scores at rest by standardized mean differences (SMD) −0.86 cm (95% confidence interval [CI] [−1.55, −0.17], P = .01) and SMD −0.93 cm (95% CI [−1.41, −0.26], P =.008) at postoperative 12 hours and 24 hours, respectively. DEX reduced pain scores while dynamic by SMD −1.63 cm (95% CI [−2.92, −0.34], P =.01) and SMD −1.78 cm (95% CI [−2.66, −0.90], P =.007) for postoperative 12 hours and 24 hours, respectively. DEX extended the duration of analgesia by weighted mean differences (WMD) 201.53 minutes (95% CI [33.45, 369.61], P =.02); and reduced cumulative postoperative analgesic consumption by WMD −7.71 mg (95% CI [−10.64, −4.78], P |
Databáze: | OpenAIRE |
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