Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis
- PMID: 38050653
- PMCID: PMC10898393
- DOI: 10.1111/iwj.14523
Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis
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.
© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Conflict of interest statement
The authors declare no conflicts of interest.
Figures
![FIGURE 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g004.gif)
![FIGURE 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g006.gif)
![FIGURE 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g005.gif)
![FIGURE 4](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g007.gif)
![FIGURE 5](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g001.gif)
![FIGURE 6](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g003.gif)
![FIGURE 7](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10898393/bin/IWJ-21-e14523-g002.gif)
Similar articles
-
Postoperative Analgesia After Wound Infiltration With Tramadol and Dexmedetomidine as an Adjuvant to Ropivacaine for Lumbar Discectomies: A Randomized-controlled Clinical Trial.J Neurosurg Anesthesiol. 2017 Oct;29(4):433-438. doi: 10.1097/ANA.0000000000000422. J Neurosurg Anesthesiol. 2017. PMID: 28266950 Clinical Trial.
-
The Effect of Dexmedetomidine Added to Preemptive Ropivacaine Infiltration on Postoperative Pain After Lumbar Fusion Surgery: A Randomized Controlled Trial.Spine (Phila Pa 1976). 2019 Oct 1;44(19):1333-1338. doi: 10.1097/BRS.0000000000003096. Spine (Phila Pa 1976). 2019. PMID: 31095117 Clinical Trial.
-
Perioperative dexmedetomidine for acute pain after abdominal surgery in adults.Cochrane Database Syst Rev. 2016 Feb 18;2(2):CD010358. doi: 10.1002/14651858.CD010358.pub2. Cochrane Database Syst Rev. 2016. PMID: 26889627 Free PMC article. Review.
-
The Effect of Dexmedetomidine on Postoperative Opioid Consumption and Pain After Major Spine Surgery.Anesth Analg. 2016 May;122(5):1646-53. doi: 10.1213/ANE.0000000000001226. Anesth Analg. 2016. PMID: 27003917 Clinical Trial.
-
Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy.Cochrane Database Syst Rev. 2014 Mar 12;2014(3):CD007049. doi: 10.1002/14651858.CD007049.pub2. Cochrane Database Syst Rev. 2014. PMID: 24619479 Free PMC article. Review.
References
-
- Apostolides PJ, Jacobowitz R, Sonntag VK. Lumbar discectomy microdiscectomy: “the gold standard”. Clin Neurosurg. 1996;43:228‐238. - PubMed
-
- Kim HJ, Lee JI, Kang KT, et al. Influence of pain sensitivity on surgical outcomes after lumbar spine surgery in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 2015;40(3):193‐200. - PubMed
-
- Allegri M, Clark MR, De Andres J, Jensen TS. Acute and chronic pain: where we are and where we have to go. Minerva Anestesiol. 2012;78(2):222‐235. - PubMed
-
- Abdel Hay J, Kobaiter‐Maarrawi S, Tabet P, et al. Bupivacaine field block with clonidine for postoperative pain control in posterior spine approaches: a randomized double‐blind trial. Neurosurgery. 2018;82(6):790‐798. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources