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| Intraperitoneal local anesthetic with Dexmedetomidine for postoperative analgesia after laparoscopic surgery: a systematic review
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| DENG Minjia1 HU Lihui1 HUANG Xiaofang1 LIU Yuling1 WU Youping2 |
1.Department of Pharmacy, General Hospital of Southern Theatre Command of People′s Liberation Army of China, Guangdong Province, Guangzhou 510010, China;
2.Department of Anesthesiology, General Hospital of Southern Theatre Command of People′s Liberation Army of China, Guangdong Province, Guangzhou 510010, China |
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Abstract Objective To assess the efficacy and safety of intraperitoneal local anesthetic with Dexmedetomidine (DEX) for postoperative analgesia after laparoscopic surgery. Methods The PubMed, EMbase, Cochrane Library, CBM, Wanfang Database, China National Knowledge Infrastructure and VIP for all randomized controlled trials about intraperitoneal local anesthetic alone (group L) or with DEX (group LD) in laparoscopic surgery were searched. The retrieval period was from the establishment of the database to August 2019. Information was extracted and the research of risk of bias was evaluated, data was analyzed by RevMan5.3 software. Results Seven RCTs involving 422 patients were included. The results showed that compared with group L, group LD first use remedy postoperative analgesia drug prolonged [MD = 58.78, 95%CI: (23.72, 93.83), P = 0.001], 24 h remedial reduction total [Diclofenac: MD = -86.27, 95%CI: (-127.95,-44.58), P ＜ 0.0001], the incidence of postoperative shoulder pain reduce [OR = 0.16, 95%CI: (0.08, 0.31), P ＜ 0.000 01]. There was no significant difference in the incidence of adverse reactions such as nausea [OR = 0.71, 95%CI: (0.34, 1.47), P = 0.36], vomiting [OR = 0.40, 95%CI: (0.16,1.01), P = 0.05] between the two groups. Conclusion Intraperitoneal local anesthetic combines with DEX can improve the analgesia effect after laparoscopic surgery without increasing the occurrence of adverse reaction.
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