Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Oct 11;18(10):e0287296.
doi: 10.1371/journal.pone.0287296. eCollection 2023.

Effects of dexmedetomidine as an adjuvant to ropivacaine or ropivacaine alone on duration of postoperative analgesia: A systematic review and meta-analysis of randomized controlled trials

Fangzhou Li  1   2   3   4 , Liang Guo  1   2   3   4 , Zijin Huang  1   2   3   4 , Fei Lin  1   2   3   4 , Linghui Pan  1   2   3   4
Affiliations
Meta-Analysis

Effects of dexmedetomidine as an adjuvant to ropivacaine or ropivacaine alone on duration of postoperative analgesia: A systematic review and meta-analysis of randomized controlled trials

Fangzhou Li et al. PLoS One. .

Abstract

Background: Ropivacaine is a long-acting local anesthetic that is used to treat postoperative pain. Adjuvant use of dexmedetomidine in regional anesthesia may prolong the duration of analgesia. The objective of this systematic review and meta-analysis was to investigate the duration and effect of ropivacaine alone vs. ropivacaine in combination with dexmedetomidine for postoperative analgesia.

Methods: The PubMed, EMBASE, Web of Science, and Google Scholar databases were searched for randomized controlled trials (RCTs) of ropivacaine alone or ropivacaine in combination with dexmedetomidine for regional anesthesia. The primary outcome was duration of analgesia, defined as the time from onset of the block to the time of the first analgesic request or initial pain report. Secondary outcomes were duration of sensory block, duration of motor block, consumption of sufentanil for analgesia, length of hospital stay, and incidence of postoperative nausea and vomiting.

Results: Eighteen studies with 1148 patients were included. Overall quality of the RCTs, as assessed by the Jadad scale, was high. The meta-analysis demonstrated that ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia from local anesthetics compared to ropivacaine alone (WMD: 4.14h; 95%CI: 3.29~5.0h; P<0.00001; I2 = 99%). There was evidence of high heterogeneity between studies. The duration of sensory and motor block was significantly increased, and consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting were significantly reduced in patients who received ropivacaine combined with dexmedetomidine compared to ropivacaine alone. There was no significant difference in length of hospital stay.

Conclusions: Compared to ropivacaine alone, ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia and sensory and motor block, and reduced consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting, across an array of surgeries.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart for study selection.
Fig 2
Fig 2. Forest plot for duration of postoperative analgesia (h), hour.
Fig 3
Fig 3. Subgroup analysis stratified by route of administration.
Fig 4
Fig 4
Forest plots for duration of sensory block(A); motor block (B); analgesic consumption of sufentanil (C) and length of hospital stay (D).
Fig 5
Fig 5
Forest plots for postoperative nausea (A) and vomiting (B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kopitko C, Czermann R, Orosz M, Hangody G, Kiss D, Szabo Z, et al.. A randomized comparative evaluation of local infiltration analgesia, extended nerve blocks, and conventional analgesia in pain management after total knee arthroplasty. Jt Dis Relat Surg. 2021;32(2):290–8. Epub 2021/06/20. doi: 10.52312/jdrs.2021.68 ; PubMed Central PMCID: PMC8343869. - DOI - PMC - PubMed
    1. Jin F, Li Z, Tan WF, Ma H, Li XQ, Lu HW. Preoperative versus postoperative ultrasound-guided rectus sheath block for improving pain, sleep quality and cytokine levels in patients with open midline incisions undergoing transabdominal gynecological surgery: a randomized-controlled trial. BMC Anesthesiol. 2018;18(1):19. Epub 2018/02/11. doi: 10.1186/s12871-018-0485-9 ; PubMed Central PMCID: PMC5807824. - DOI - PMC - PubMed
    1. Chocron Y, Aljerian A, Thibaudeau S. Upper-Extremity Nerve Decompression Under Local Anesthesia: A Systematic Review of Methods for Reduction of Postoperative Pain and Opioid Consumption. Hand (N Y). 2020;15(4):447–55. Epub 2019/04/16. doi: 10.1177/1558944719843635 ; PubMed Central PMCID: PMC7370381. - DOI - PMC - PubMed
    1. Zhu G, Kang Z, Chen Y, Zeng J, Su C, Li S. Ultrasound-guided stellate ganglion block alleviates stress responses and promotes recovery of gastrointestinal function in patients. Dig Liver Dis. 2021;53(5):581–6. Epub 2020/12/12. doi: 10.1016/j.dld.2020.11.028 . - DOI - PubMed
    1. Kaye AD, Chernobylsky DJ, Thakur P, Siddaiah H, Kaye RJ, Eng LK, et al.. Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain. Curr Pain Headache Rep. 2020;24(5):21. Epub 2020/04/03. doi: 10.1007/s11916-020-00853-z ; PubMed Central PMCID: PMC7223065. - DOI - PMC - PubMed

MeSH terms