The Knee · 2025
Efficacy and systemic safety of adding intra-articular dexmedetomidine as adjuvant therapy to bupivacaine for post-operative analgesia in knee arthroscopic procedures: a systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Khan Muhammad Sohaib, Moeen Wania, Shuja Muhammad Hamza, Mohammed Yasmine Adel, Khan Wajeeh Ahmed, Farooqi Mobeen, Abd-ElGawad Mohamed, Danish Mohammad, Jansher Muhammad, Anjum Muhammad Umair, Mahmmoud Fadelallah Eljack Mohammed, Haque Md Ariful
Аннотация
BACKGROUND: Various analgesic methods have been evaluated for knee arthroscopy, but adequate pain control after arthroscopic procedures has been a challenge. This meta-analysis compares intra-articular bupivacaine with intra-articular bupivacaine plus dexmedetomidine, for post-op pain control after knee arthroscopy.
METHODS: Adhering to the PRISMA guidelines we performed a thorough literature review and selected all the studies meeting our inclusion criteria (CD42024559371). Quality assessment was performed using the ROB II tool. A Random Effect (RE) model was used for analysis.
RESULTS: Eight studies with 386 patients met the inclusion criteria. Combining Dexmedetomidine with Bupivacaine delays the need for first analgesic use compared to Bupivacaine alone (SMD: 4.09, 95 % CI [2.61 to 5.57], p < 0.00001). Adverse events were minimal and comparable between groups in most studies. For patients who underwent knee arthroscopy under spinal anesthesia, Visual Analogue Scale scores at rest (VAS-r) and VAS scores during movement (VAS-m) showed significant differences favoring Bupivacaine and Dexmedetomidine from 4 h onward. VAS-m and VAS-r scores of patients who received general anesthesia displayed significant differences favoring Bupivacaine and Dexmedetomidine at 4 h only (SMD = -2.82 (95 % CI [-3.77 to -1.86], p < 0.00001, I2 = 55 %) and (SMD = -1.57 (95 % CI [-2.02 to -1.11], p < 0.00001, I2 = 0 %), respectively.
CONCLUSION: The combination of bupivacaine and dexmedetomidine for managing post-arthroscopic pain offers superior pain relief compared to bupivacaine alone, especially under spinal anesthesia. Further research is warranted to confirm these findings.
PLAIN LANGUAGE SUMMARY: Adding dexmedetomidine to bupivacaine significantly delays the need for the first analgesic dose after knee arthroscopy. Pain relief is superior, especially under spinal anesthesia, with improved pain scores at rest and during movement from 4 h onward. Adverse effects are minimal and comparable to bupivacaine alone, in most studies.
METHODS: Adhering to the PRISMA guidelines we performed a thorough literature review and selected all the studies meeting our inclusion criteria (CD42024559371). Quality assessment was performed using the ROB II tool. A Random Effect (RE) model was used for analysis.
RESULTS: Eight studies with 386 patients met the inclusion criteria. Combining Dexmedetomidine with Bupivacaine delays the need for first analgesic use compared to Bupivacaine alone (SMD: 4.09, 95 % CI [2.61 to 5.57], p < 0.00001). Adverse events were minimal and comparable between groups in most studies. For patients who underwent knee arthroscopy under spinal anesthesia, Visual Analogue Scale scores at rest (VAS-r) and VAS scores during movement (VAS-m) showed significant differences favoring Bupivacaine and Dexmedetomidine from 4 h onward. VAS-m and VAS-r scores of patients who received general anesthesia displayed significant differences favoring Bupivacaine and Dexmedetomidine at 4 h only (SMD = -2.82 (95 % CI [-3.77 to -1.86], p < 0.00001, I2 = 55 %) and (SMD = -1.57 (95 % CI [-2.02 to -1.11], p < 0.00001, I2 = 0 %), respectively.
CONCLUSION: The combination of bupivacaine and dexmedetomidine for managing post-arthroscopic pain offers superior pain relief compared to bupivacaine alone, especially under spinal anesthesia. Further research is warranted to confirm these findings.
PLAIN LANGUAGE SUMMARY: Adding dexmedetomidine to bupivacaine significantly delays the need for the first analgesic dose after knee arthroscopy. Pain relief is superior, especially under spinal anesthesia, with improved pain scores at rest and during movement from 4 h onward. Adverse effects are minimal and comparable to bupivacaine alone, in most studies.