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Meta-Analysis
. 2024 Mar;21(3):e14523.
doi: 10.1111/iwj.14523. Epub 2023 Dec 5.

Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis

Affiliations
Meta-Analysis

Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis

Xiaoping Wang et al. Int Wound J. 2024 Mar.

Abstract

In a meta-study, we evaluated the effectiveness and security of the combination of topical anaesthetic and dexmedetomidine in the treatment of postoperative pain in patients with lumbar disease. Four databases were systematically searched for possible related articles. Only English-language research was taken into account on the Internet. Furthermore, we only took into account the studies that were published prior to 2023. Only those that fulfilled the eligibility criteria were considered: (1) in adults who were about to undergo spine operation, (2) dexmedetomidine combined with local anaesthesia, (3) Visual Analog Scale scores at 4 and 24 h after the event and (4) this was a randomized or nonrandomized, controlled study. The meta-analysis was carried out with Revman 5.3 software. A ROBINS-I-based instrument was used to evaluate controlled studies. All trials were synthesized by computing the end results with either a fixed or a random effect model, which was dependent on statistical diversity. Five trials showed a marked reduction in wound pain at 4 h after the operation in patients who were treated with dexmedetomidine for lumbar spinal surgery (MD, -0.81; 95% CI, -1.24, -0.35; p = 0.0005). In the case of lumbar spinal operations, the addition of dexmedetomidine to the postoperative treatment resulted in a marked reduction in the pain at 24 h post-operation (MD, -0.64; 95% CI, -0.79, -0.48; p < 0.0001). The quality of the data we evaluated was 'moderate' to 'good'; thus, we have limited confidence in the impact estimation, and the actual impact might be significantly different from what we had expected. Additional studies should concentrate on practices that are well known to cause severe postoperative pain, especially for cases where the improvement of pain management may lead to substantial clinical benefits in terms of reduction of morbidity or cost-effectiveness in terms of quicker healing and release.

Keywords: VAS score; dexmedetomidine; wound infiltration; wound pain.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the study.
FIGURE 2
FIGURE 2
Risk of bias diagram.
FIGURE 3
FIGURE 3
Summary of risk of bias.
FIGURE 4
FIGURE 4
Forest plot of effect of postoperative addition of dexmedetomidine in lumbar spine surgery patients on patients' wound pain at 4 h postoperatively.
FIGURE 5
FIGURE 5
Forest plot of effect of postoperative addition of dexmedetomidine in patients undergoing lumbar spine surgery on patients' wound pain at 24 h postoperatively.
FIGURE 6
FIGURE 6
Funnel plot of the effect of the postoperative addition of dexmedetomidine on patients' 4‐h postoperative wound pain in patients undergoing lumbar spine surgery.
FIGURE 7
FIGURE 7
Funnel plot of the results of the effect of postoperative addition of dexmedetomidine in patients undergoing lumbar spine surgery on patients' wound pain at 24 h postoperatively.

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