Comparison between bupivacaine–dexmedetomidine mixture and bupivacaine–magnesium mixture when used for wound infiltration before skin incision in surgeries for hernia repair regarding their intraoperative and postoperative analgesic effects

Abdelnaim, Hala Ezzat; Mohamed, Nashwa Nabil; Saleh, Azza; Youssef, Ahmad

doi:10.1186/s42077-018-0012-8

Cited by 6 publications

(20 citation statements)

References 20 publications

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“…Another important finding of our study was significant higher sedation scores in the Group BD at the first three time points (i.e., 1, 2, and 3 h after surgery) as well as longer emergence time in this group, which indicate deeper sedation in Group BD, which is similar to the results reported by Xiang et al [18] and others. In the study by Abdelnaim et al [29], the researchers reported significantly higher Ramsay sedation scores in the Group BD compared with BO and DEX + magnesium groups, which confirms the results of our study. It has been previously indicated that IV administration and infiltration of DEX results in greater sedation compared with normal saline [30].…”

Section: Discussionsupporting

confidence: 92%

Effects of adding dexmedetomidine to local infiltration of bupivacaine on postoperative pain in pediatric herniorrhaphy: a randomized clinical trial

Azemati

Pourali

Aghazadeh

2020

Korean J Anesthesiol

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Indirect inguinal hernia, caused by a patent processus vaginalis, is a common pathology in the first year of life, especially in low-birth weight male neonates [1]. Surgery (inguinal herniorrhaphy) is considered to be the first-line treatment, in which various techniques, such as open and laparoscopic procedures, have been proposed [2]. Nevertheless, despite the variety of techniques proposed for correction of inguinal hernia, herniorrhaphy is associated with severe adverse effects, such as recurrence, and persistent postoperative pain [3,4].

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Section: Discussionsupporting

confidence: 92%

Effects of adding dexmedetomidine to local infiltration of bupivacaine on postoperative pain in pediatric herniorrhaphy: a randomized clinical trial

Azemati

Pourali

Aghazadeh

2020

Korean J Anesthesiol

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“…Eight studies 16,22‐24,27,31,34,38 involved wound infiltration before skin incision, and 15 studies 17‐21,25,26,28‐30,32,33,35‐37 concerned wound infiltration before skin closure. The types of local anaesthetics include ropivacaine, 18,20,22‐26,28,30,33,36‐38 bupivacaine 16,17,19,21,29,31,32,34,35 and lidocaine 27 . The concentrations of ropivacaine were 0.2%, 20,22,23,30 0.3%, 26,33,36 0.375%, 25 0.5% 24,28,38 and 0.75% 18,37 ; the concentrations of bupivacaine were 0.25% 17,19,21,29,31,32,34,35 and 0.5% 16 ; and the concentration of lidocaine was 2.0% 27 .…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia: A meta‐analysis with trial sequential analysis of 23 randomised controlled trials

Ren

Wei

Liu

et al. 2020

International Wound Journal

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To further identify the real efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia, we conducted this meta‐analysis. The systematic search strategy was performed using PubMed, Embase, Cochrane Library, and Chinese databases. As a result, a total of 23 RCTs (1445 patients) were included. Patients receiving dexmedetomidine combined with local anaesthetics had a lower rescue analgesia rate [risk ratio (RR): 0.48; 95% confidence interval (CI): 0.36‐0.65] and lower rescue analgesic consumption [weighted mean difference (WMD): −10.80 mg; 95%CI: −13.28 to −8.31 mg] than patients receiving local anaesthetics alone. The dexmedetomidine‐related adverse reactions included bradycardia (RR: 1.33; 95%CI: 0.32‐5.56) and hypotension (RR: 3.00; 95%CI: 0.49‐18.42). In addition, the time to first analgesic request (WMD: 296.16 minutes; 95%CI: 165.69 minutes ~ 426.63 minutes), incidence of postoperative nausea and vomiting (PONV) and pain scores at 4 hours postoperatively were also significantly lower in patients receiving dexmedetomidine combined with local anaesthetics. This meta‐analysis demonstrated that the use of dexmedetomidine as an adjuvant to wound infiltration is effective for reducing the rescue analgesia rate, rescue analgesic consumption and PONV. In addition, limited evidence shows that dexmedetomidine can prolong postoperative analgesia for approximately 5 hours. Further investigations on dexmedetomidine‐related adverse reactions and the dose–response effect of dexmedetomidine in wound infiltration are warranted.

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“…In our study, there were no statistically significant differences in MAP (mean arterial pressure), heart rate and respiratory rate among the three groups. The study by Aksu et al 18 , addition of dexmedetomidine to the bupivacaine for TAP block and the study by Abdelnaim et al 11 , addition of dexmedetomidine to the bupivacaine wound infiltration for herniorrhaphy surgeries showed that there was no statistically significant difference in the incidence of nausea and vomiting. Similar to them, in our current study, there was no significant difference in the incidence of nausea vomiting among the groups (p>0.05) ( Table 5).…”

Section: Discussionmentioning

confidence: 99%

“…Study by Abdelnaim et al. 11 demonstrated that addition of dexmedetomidine with local anesthetics to wound infiltration reduces postoperative pain and also reduces the analgesic requirement which was explained by different mechanisms. The probable mechanisms are inhibition of pain conduction in C-fibers, decreasing the production of inflammatory cytokines, vasoconstrictive effect of alpha 2 agonists on vascular smooth muscle prolongs the time of analgesia.…”

Section: Discussionmentioning

confidence: 99%

“…Infiltration with local anesthetics may also participate in providing adequate pain control after anorectal surgeries 7 . Few studies have investigated the effects of addition of pharmacological agents like dexmedetomidine 10,11,18 , fentanyl 14 , etc to the incisional wound infiltration in various surgeries 12 . Few studies have investigated the effects of addition of ketamine 6 , dexmedetomidine 5 etc to perianal local anaesthetic infiltration in perianal surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of analgesic efficacy of bupivacaine, bupivacaine with dexmedetomidine, and bupivacaine with fentanyl in local perianal infiltration technique in perianal surgeries: A prospective, randomized controlled study

Haribabu¹

2020

MIJOANS

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Background: Numerous methods have been proposed to alleviate pain after perianal surgeries but the role of addition of Dexmedetomidine or fentanyl to bupivacaine as local infiltration in surgical wound for post-operative analgesic effect is less explored. Hence a study was conducted to compare the efficacy of wound infiltration with bupivacaine, bupivacaine with fentanyl and bupivacaine with Dexmedetomidine for post-operative analgesia following perianal surgeries. Methods: 75 patients with ASA physical status of I and II scheduled for perianal surgeries were recruited for the study. The patients were randomly assigned into 3 groups namely DM, F and C. Group DM received perianal wound infiltration with 0.5% bupivacaine 15ml which included Dexmedetomidine 1.5 µg /kg, Group F received perianal wound infiltration with 0.5% bupivacaine 15 ml which included Fentanyl 2µg/ml and Group C received perianal wound infiltration with 0.5% bupivacaine 15 ml which included 1 ml saline. Post-operative quality of analgesia was assessed by VAS (0-10) for 24 h and rescue analgesic was administered when VAS > 4. Pain score at the time of defecation was also noted. Total dose of analgesic needed in 24 hours and side effects were noted. Results: Group DM had significantly longer duration of postoperative analgesia when compared with Group F and group C. Group F had prolonged postoperative analgesia when compared to Group C. The pain score at first defecation was significantly lower in Group DM when compared to both Group F and Group C. None of the patients developed skin rash, respiratory depression, hypotension, hypoxemia, and there were no significant tachycardia or bradycardia. Conclusions: Perianal wound infiltration with Dexmedetomidine-bupivacaine mixture provides prolonged analgesia, and decreases the total analgesic consumption in patients undergoing perianal surgeries.

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Comparison between bupivacaine–dexmedetomidine mixture and bupivacaine–magnesium mixture when used for wound infiltration before skin incision in surgeries for hernia repair regarding their intraoperative and postoperative analgesic effects

Cited by 6 publications

References 20 publications

Effects of adding dexmedetomidine to local infiltration of bupivacaine on postoperative pain in pediatric herniorrhaphy: a randomized clinical trial

Effects of adding dexmedetomidine to local infiltration of bupivacaine on postoperative pain in pediatric herniorrhaphy: a randomized clinical trial

Efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia: A meta‐analysis with trial sequential analysis of 23 randomised controlled trials

Comparison of analgesic efficacy of bupivacaine, bupivacaine with dexmedetomidine, and bupivacaine with fentanyl in local perianal infiltration technique in perianal surgeries: A prospective, randomized controlled study

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