Effect of local wound infiltration with ketamine versus dexmedetomidine on postoperative pain and stress after abdominal hysterectomy, a randomized trial

Mohamed, Sahar Abdel-Baky; Sayed, Douaa; Sherif, Fatma Adel El; El-Rahman, Abd

doi:10.1002/ejp.1181

Cited by 33 publications

(57 citation statements)

References 33 publications

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“…The search identified 251 studies, of which 198 were eliminated from further review because of not controlled trials or were duplications; after reviewing the abstracts, an additional 48 trials were excluded because they were not relevant to our study. Finally, the articles considered to be suitable for the meta‐analysis consisted of five RCTs, enrolling a total of 294 adult patients. The search process is shown in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…Of the five studies, two studies were from India, two studies were from China, and one study was from Egypt. Four studies involved local wound infiltration at the end of the operation, and one study concerned local wound infiltration before the operation. Among them, local anaesthetics were ropivacaine in three studies, and bupivacaine in the other two studies .…”

Section: Resultsmentioning

confidence: 99%

“…Four studies involved local wound infiltration at the end of the operation, and one study concerned local wound infiltration before the operation. Among them, local anaesthetics were ropivacaine in three studies, and bupivacaine in the other two studies . The concentration range of ropivacaine was 0.3%‐0.75%; concentration of bupivacaine was 0.25%.…”

Section: Resultsmentioning

confidence: 99%

“…The dosage of DEX fluctuated between 0.5 μg/kg and about 1.5 μg/kg in all studies. Three studies evaluated the VAS scores at 6, 12, and 24 hours in the postoperative period, four studies described the total analgesic consumption within 24 hours after surgery and analysed the incidence of PONV. The detailed characteristics of all the included studies are shown in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Does DEX provide a similar effect on local wound infiltration in abdominal operation? At present, some clinical randomised controlled trials (RCTs) have studied this problem . Therefore, we wanted to see whether DEX could improve analgesia when used in combination with local anaesthetics for wound infiltration after abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Ren

Shi

Chen

et al. 2019

International Wound Journal

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To assess the efficacy and safety of dexmedetomidine (DEX) as an adjuvant to local wound infiltration anaesthesia in abdominal surgery, we conducted this meta‐analysis. First, the systematic search strategy was performed on PubMed, Embase, and Cochrane Library and five randomised controlled trials (RCTs) involving 294 patients were included. Then, the outcome data were extracted from the studies and their effect sizes were calculated using Review Manager 5. As a result, the addition of DEX significantly reduced visual analogy scores at 6 hours after surgery (mean difference = −0.53[−0.82, −0.25], P < .001), 12 hours after surgery (mean difference = −0.39 [−0.73, −0.05]; P = .03), and 24 hours after surgery (mean difference = −0.20 [−0.29, −0.11], P < .001) and reduced total analgesic consumption within 24 hours after surgery (mean difference = −4.92 [−9.00, −0.84]; P = .02) compared with placebo groups. However, there was no difference in the incidence of postoperative nausea and vomiting (risk ratio = 0.68 [0.41, 1.14]; P = .14). In summary, DEX as a local anaesthetic adjuvant added for local wound infiltration anaesthesia in abdominal surgery could reduce visual analogy scores and postoperative analgesic consumption without changing incidence of postoperative nausea and vomiting.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Ren

Shi

Chen

et al. 2019

International Wound Journal

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Low‐dose spinal and opioid‐free anesthesia in patient with Severe Aortic Stenosis and SARS‐CoV‐2 infection: Case report

Coviello

Ianniello

Spasari

et al. 2021

Clinical Case Reports

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Effect of local infiltration with oxytocin on hemodynamic response to surgical incision and postoperative pain in patients having open laparoscopic surgery under general anesthesia

Zayas-González

González‐Hernández

Manzano‐García

et al. 2019

European Journal of Pain

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Background Preemptive analgesia encompasses different perioperative interventions that have the final aim of decreasing postoperative pain and improving recovery. Recently, peripheral analgesic effects of oxytocinergic modulation have been suggested. In this regard, we tested the potential analgesic effects of subcutaneous oxytocin (OT) infiltration in patients submitted to laparoscopic cholecystectomy. Methods Thirty patients with similar general characteristics and medical physical conditions were evaluated. The patients were assigned by simple random selection to one of three groups: (a) OT group (n = 10), which received preincisional subcutaneous OT (4 µg/4 ml saline) in the surgical sites for trocar placements; (b) Lidocaine group (n = 10), which received subcutaneous lidocaine 1% (4 ml) in the surgical sites; and (c) Control group (n = 10), which did not receive any treatment. Then we measured the effect of those treatments on the hemodynamic variations produced as responses to the surgical incisions and trocar insertions (open port placements using the Hasson technique). Moreover, we assessed the intensity of postoperative pain with the visual analogue scale during recovery and 24 hr after surgery. Results Hemodynamic parameters were stable in both intervention groups (subcutaneous OT and lidocaine) during the surgical incisions and trocar placements, whereas a most likely sympathetic activation due to trocar insertions (open port placements) was not blunted in the placebo group. Furthermore, postoperative pain was diminished in both OT and lidocaine groups when compared to the control group. Conclusions Preincisional subcutaneous OT administration reduced the hemodynamic response produced by the latter. Furthermore, OT also diminished postoperative pain.

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Effect of local wound infiltration with ketamine versus dexmedetomidine on postoperative pain and stress after abdominal hysterectomy, a randomized trial

Abstract: Local wound infiltration with ketamine or dexmedetomidine added to bupivacaine had an opioid-sparing effect, delayed first request of rescue analgesia, and attenuated postoperative stress response, especially with ketamine in patients underwent total abdominal hysterectomy.

Cited by 33 publications

References 33 publications

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Low‐dose spinal and opioid‐free anesthesia in patient with Severe Aortic Stenosis and SARS‐CoV‐2 infection: Case report

Effect of local infiltration with oxytocin on hemodynamic response to surgical incision and postoperative pain in patients having open laparoscopic surgery under general anesthesia

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