Comparison of dexmedetomidine and ketamine in adjuvant with morphine for postoperative pain management following lumbar fusion surgery

Jelodar, Abdolmajid Gholinataj; Makrani, Nafiseh Faghani; Shafizad, Misagh; Saeidiborojeni, Hamidreza; Kiabi, Farshad Hassanzadeh; Ebrahimian, Mostafa

doi:10.1016/j.inat.2023.101767

Cited by 7 publications

(2 citation statements)

References 7 publications

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“…The reviewer thoroughly assessed the methodological quality and risk of bias of the 15 included studies [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] using a modified ROBVIS tool (Figure 2). Overall, the studies were well conducted, with low risk of bias ratings across most domains.…”

Section: The Quality Assessmentmentioning

confidence: 99%

“…Outcome assessors were blinded in all the randomized trials, overcoming detection bias. Attrition and reporting bias were minimal, as most studies had complete outcome data and fully reported their pre-specified outcomes [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67]. Overall judgments took these minor uncertainties into account, but the studies were still considered to have a reasonably low risk of bias.…”

Section: The Quality Assessmentmentioning

confidence: 99%

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Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review

Aldanyowi

2023

Life

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Effective postoperative pain management is critical for recovery after orthopedic surgery, but often remains inadequate despite multimodal analgesia. This systematic review synthesizes evidence on innovative modalities for enhancing pain control following major orthopedic procedures. Fifteen randomized controlled trials and comparative studies evaluating peripheral nerve blocks, local anesthetic infiltration, cryotherapy, transcutaneous electrical stimulation, adjunct medications, and other techniques are included. Thematic analysis reveals that peripheral nerve blocks and local anesthetic infiltration consistently demonstrate reduced pain scores, opioid consumption, and side effects versus conventional analgesia alone. Oral multimodal medications also show promise as part of opioid-sparing regimens. Adjunctive approaches like cryotherapy, music, and dexmedetomidine require further research to optimize protocols. Despite promising innovations, critical knowledge gaps persist regarding comparative effectiveness, optimal interventions and dosing, combination strategies, cost-effectiveness, and implementation. High-quality randomized controlled trials using standardized protocols are essential to guide the translation of enhanced multimodal regimens into clinical practice. This review provides a framework for pursuing research priorities and advancing evidence-based postoperative pain management across orthopedic surgeries.

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Section: The Quality Assessmentmentioning

confidence: 99%

Section: The Quality Assessmentmentioning

confidence: 99%

Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review

Aldanyowi

2023

Life

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Comparative Study of the Effects of Clonidine and Tranexamic Acid on Intraoperative Bleeding in Rhinoplasty: A Clinical Trial

Heydari,

Safdari,

Hemmatpoor

2024

JPRAS Open

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The impact of oral melatonin on pain and anxiety reduction during venipuncture in pediatric patients: a double-blind randomized clinical trial

Rahafard,

Akbari Jokar,

Hosseini

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Pain resulting from therapeutic procedures and injections is a prevalent source of stress for children. Immediate side effects of pain in infants include syncope, irritability, sleep disturbances, and nutritional issues. This study aimed to investigate the effects of oral melatonin on alleviating pain and anxiety in pediatric patients undergoing venipuncture. Methods: This double-blind, randomized controlled trial was conducted in the pediatric emergency ward. Patients were randomly assigned to one of two groups; the intervention group received 0.5 mg/kg of oral melatonin (maximum 5 mg) 30 min before venipuncture, while the placebo group received an equivalent amount of a placebo 30 min before the procedure. Using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, postcanulation fear, pain severity, compliance, and potential side effects were evaluated. Results: In total, 202 patients (113 male and 89 female) in the intervention and control groups were included in the analysis. The mean pain score during venipuncture was 1.52±3.04 in the intervention group and 2.04±6.57 in the control group (P<0.001). In the intervention group, only 19 (18.8%) patients reported pain during venipuncture, whereas 79 (78.2%) patients in the control group reported pain (P<0.001). Less than half (44.6%) of the patients in the intervention group experienced anxiety during venipuncture, while the majority (94.1%) of the patients in the control group exhibited anxiety (P<0.001). The venipuncture success rate was 60.4% in the intervention group and 51.5% in the control group (P=0.257). Conclusion: Administering 0.5 mg/kg of oral Melatonin 30 min before venipuncture reduces procedure-related pain and anxiety in pediatric patients and may be associated with higher venipuncture success rates.

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Comparison of dexmedetomidine and ketamine in adjuvant with morphine for postoperative pain management following lumbar fusion surgery

Cited by 7 publications

References 7 publications

Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review

Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review

Comparative Study of the Effects of Clonidine and Tranexamic Acid on Intraoperative Bleeding in Rhinoplasty: A Clinical Trial

The impact of oral melatonin on pain and anxiety reduction during venipuncture in pediatric patients: a double-blind randomized clinical trial

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