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British Journal of Anaesthesia Feb 2017The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus... (Meta-Analysis)
Meta-Analysis Review
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done. Relevant studies were randomized clinical trials in patients 0-18 years old comparing PVB (single shot or continuous catheter) with any comparator and analgesic medication. Pain scores, rescue analgesia and adverse events were compared.The systematic reviews identified six trials enrolling 358 paediatric patients. PVB medications included bupivacaine, ropivacaine, lidocaine, and fentanyl. Surgical procedures included inguinal herniorraphy, cholecystectomy, and appendectomy. The standardized mean difference in early pain scores favoured PVB: 0.85 [95% confidence interval (CI) 0.12-1.58] at 4-6 h and 0.64 (95% CI 0.28-1.00) at 24 h. One study reported a reduced length of stay. Parental [odds ratio (OR) 5.12 (95% CI 2.59-10.1)] and surgeon [OR 6.05 (95% CI 2.25-16.3)] satisfaction were higher in those receiving a PVB. No major complications occurred with a PVB.PVB resulted in minimally improved pain scores for up to 24 h after surgery, reduced rescue analgesia requirements, and increased surgeon and parental satisfaction. PVB is a good alternative to caudal and ilioinguinal block in paediatric abdominal surgery.
Topics: Abdomen; Adolescent; Child; Child, Preschool; Humans; Nerve Block; Pain, Postoperative; Randomized Controlled Trials as Topic
PubMed: 28100519
DOI: 10.1093/bja/aew387 -
Frontiers in Pediatrics 2023This study aims to evaluate the efficacy of dexmedetomidine as an adjuvant to ropivacaine in prolonging postoperative analgesia and reducing pain scores in children... (Review)
Review
Analgesic effect of ropivacaine combined with dexmedetomidine in the postoperative period in children undergoing ultrasound-guided single-shot sacral epidural block: A systematic review and meta-analysis.
OBJECTIVE
This study aims to evaluate the efficacy of dexmedetomidine as an adjuvant to ropivacaine in prolonging postoperative analgesia and reducing pain scores in children undergoing surgery.
METHODS
Five online databases were searched for RCTs on postoperative analgesia of pediatric patients undergoing ultrasound-guided single-shot sacral epidural block with dexmedetomidine as an adjuvant to ropivacaine up to January 2, 2023. Pain score and sedation score at 2, 4, 8, 12, and 24 h after the operation, the time of first receiving additional analgesic drugs, and the number of postoperative adverse effects were selected to compare the efficacy and safety of combined treatment with ropivacaine alone for pediatrics. The standard mean difference (SMD) or odds ratio (OR) and the corresponding 95% confidence interval (95%CI) were calculated by using a random-effects model.
RESULTS
A total of 295 articles were retrieved, but only 20 records were included in this meta-analysis. The results showed that dexmedetomidine combined with ropivacaine for sacral epidural block in children undergoing ultrasound-guided single-shot sacral epidural block had a more prolonged analgesia effect (SMD = 3.47, 95%CI: 2.80, 4.14). There were lower analgesia scores at 2 h(T), 4 h(T), 8 h(T), 12 h(T), and 24 h(T) in postoperative period ( : SMD = -1.02, 95%CI: -1.31, -0.72; : SMD = -1.02, 95%CI: -1.32, -0.72; : SMD = -0.84, 95%CI: -1.12, -0.56; : SMD = -0.61, 95%CI: -1.03, -0.20; : SMD = -1.03, 95%CI: -1.28, -0.78). And the incidence of adverse effects was similar between the two groups (OR = 0.84, 95%CI: 0.59, 1.18).
CONCLUSIONS
The results of this review and meta-analysis support that dexmedetomidine, as an adjuvant to ropivacaine, can improve postoperative analgesia of surgery and significantly prolong the analgesic time in children, with a similar incidence rate of adverse symptoms when compared with ropivacaine alone.
PubMed: 37063658
DOI: 10.3389/fped.2023.1099699 -
Revista Espanola de Anestesiologia Y... Oct 2021Regional anesthesia as a component of multimodal analgesia protocols has become more and more a part of modern perioperative pain management. The widespread adoption of... (Review)
Review
Regional anesthesia as a component of multimodal analgesia protocols has become more and more a part of modern perioperative pain management. The widespread adoption of ultrasound guidance in regional anesthesia has surely played an important role in that growth and it has significantly improved patient safety, decreased the incidence of block failure, cardiac arrest, and reduced complication rates. The objective of this systematic review is to extract, analyze, and synthesize clinical information about bupivacaine and ropivacaine related cardiac arrest that we might have a clearer picture of the clinical presentation. The literature search identified 268 potentially relevant publications and 22 relevant case reports were included in the review. Patients' demographics, types of regional anesthesia, hypotension, heart rhythm disorders, seizures, cardiac arrest, fatal outcome, recommendations and limitations on prevention and treatment of bupivacaine and ropivacaine related cardiac arrest are analyzed and discussed in the systematic review. Both bupivacaine and ropivacaine-induced local anesthetic toxicity can result in cardiac arrest. Lipid emulsion, telemetry, local anesthetic toxicity resuscitation training appears to be promising in improvement of survival but more research is needed. Improvement and encouragement of reporting the local anesthetic toxicity are warranted to improve the quality of information that can be analyzed in order to make more precise conclusion.
Topics: Anesthesia, Conduction; Anesthetics, Local; Bupivacaine; Heart Arrest; Humans; Ropivacaine
PubMed: 34538765
DOI: 10.1016/j.redare.2020.10.005 -
Anesthesiology and Pain Medicine Jun 2023The type of anesthesia in cesarean section can affect the mother and baby. This study aimed to determine the comparative effect of intrathecal hyperbaric bupivacaine vs....
A Comparative Study on the Effect of Intrathecal Bupivacaine vs. Ropivacaine on Maternal and Neonatal Outcomes After Cesarean Section: A Systematic Review and Meta-analysis.
CONTEXT
The type of anesthesia in cesarean section can affect the mother and baby. This study aimed to determine the comparative effect of intrathecal hyperbaric bupivacaine vs. hyperbaric ropivacaine on maternal and neonatal outcomes after cesarean section.
EVIDENCE ACQUISITION
PubMed, Web of Science, Embase, Google Scholar, IranDoc, MagIran, and Scopus databases were searched from 1 September 2022 to 1 November 2022. Eighteen clinical trials with 1542 patients were included in the analysis.
RESULTS
There was no statistically significant difference in hypotension, bradycardia, and Apgar score between the 2 groups (P > 0.05). The risk of nausea (relative risk (RR), 1.526; 95% CI, 1.175 - 1.981; P = 0.001) and vomiting (RR, 1.542; 95% CI, 1.048 - 2.268; P = 0.02) caused by bupivacaine was 0.53% and 0.54% higher than that of ropivacaine. The incidence of shivering (RR, 2.24; 95% CI, 1.480 - 3.39; P = 0.00) was 2.24 times higher in the bupivacaine group than in the ropivacaine group. The average onset time of sensory block (standardized mean difference (SMD), -0.550; 95% CI, -1.054 to -0.045; P = 0.032) and motor block (SMD, -0.812; 95% CI, -1.254 to -0.371; P = 0.000) was significantly lower in the bupivacaine group than in the ropivacaine group.
CONCLUSIONS
Despite the fact that ropivacaine and bupivacaine are effective in cesarean section, ropivacaine is more favorable because of less hemodynamic changes, less duration of sensory and motor block, and fewer side effects, which are effective in patient recovery.
PubMed: 38021336
DOI: 10.5812/aapm-134732 -
International Journal of Surgery... Aug 2017Pain is one of the important reasons for delayed discharge and Enhanced Recovery After Surgery (ERAS) after laparoscopic cholecystectomy. To assess the benefits and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pain is one of the important reasons for delayed discharge and Enhanced Recovery After Surgery (ERAS) after laparoscopic cholecystectomy. To assess the benefits and disadvantage of intraperitoneal instillation of ropivacaine in people undergoing laparoscopic cholecystectomy.
METHODS
We searched the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Science Citation Index Expanded to December 2016 to identify randomised clinical trials of relevance to this review. We analysed the data with Review Manager 5 analysis.
MAIN RESULTS
We identified 12 suitable studies. A total of 853 participants were randomised to intraperitoneal ropivacaine instillation (442 participants) versus "no intraperitoneal ropivacaine instillation" (411 participants). The pain scores as measured by the visual analogue scale (VAS) were significantly lower in the ropivacaine instillation group than the control group at 4-8 h (10 trials; 751 participants; MD -0.64 cm; 95% CI -0.86 to -0.43; p < 0.00001) and at 9-24 h (9 trials; 582 participants; MD -0.47 cm; 95% CI -0.66 to -0.28; p < 0.00001).The proportion of people who developed the adverse events were less in the ropivacaine instillation group than the control group(RR 0.60; 95% CI 0.45 to 0.79; p = 0.0002). There was no significant difference in the Post-anesthesia care unit (PACU) stay time between the two groups (3 trials; 197 participants; MD -3.77 min; 95% CI -10.24 to 2.69). The overall quality of evidence was very low. Further trials are necessary.
Topics: Adult; Amides; Anesthetics, Local; Cholecystectomy, Laparoscopic; Female; Humans; Infusions, Parenteral; Length of Stay; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Randomized Controlled Trials as Topic; Ropivacaine; Treatment Outcome
PubMed: 28669869
DOI: 10.1016/j.ijsu.2017.06.043 -
Minerva Anestesiologica Oct 2022This review and meta-analysis comprehensively elaborated the analgesic and sedative effects of ropivacaine combined with dexmedetomidine in epidural labor analgesia, and... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This review and meta-analysis comprehensively elaborated the analgesic and sedative effects of ropivacaine combined with dexmedetomidine in epidural labor analgesia, and its possible resulting motor block and adverse reactions.
EVIDENCE ACQUISITION
PubMed, Web of science, Cochrane, China National Knowledge Infrastructure and WANFANG DATA were searched for randomized controlled trials (RCTs) on the efficacy and safety of ropivacaine combined with dexmedetomidine in epidural labor analgesia. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated.
EVIDENCE SYNTHESIS
As of September 10, 17 articles were finally included for meta-analysis. The results showed that compared with the control group (ropivacaine alone or ropivacaine + sufentanil), singleton full-term pregnant patients treated with ropivacaine + dexmedetomidine had better analgesic and sedative effects, with lower VAS scores at 15 min (T
1 ), 30 min (T2 ), 1 h (T3 ), 2 h (T4 ) after labor analgesia, and the moment of delivery (T5 ) (T1 : SMD=-1.90, 95% CI: -2.39, -1.40; T2 : SMD=-1.43, 95% CI: -1.92, -0.93; T3 : SMD=-0.91, 95% CI: -1.41, -0.41; T4 : SMD=-0.94, 95% CI: -1.54, -0.34; T5 : SMD=-0.56, 95% CI: -1.02, -0.10) and higher Ramsay scores at 15 min (T1 ) and 30 min (T2 ) after labor analgesia (T1 : SMD=1.17, 95% CI: 0.80, 1.53; T2 : SMD=2.17, 95% CI: 1.30, 3.03).CONCLUSIONS
In patients with singleton full-term pregnancy, ropivacaine + dexmedetomidine have better analgesic and sedative effects than in the control group. Both groups have no significant motor block and neonatal asphyxia and hypoxia.
Topics: Amides; Analgesia, Epidural; Analgesia, Obstetrical; Analgesics; Anesthetics, Local; Dexmedetomidine; Female; Humans; Hypnotics and Sedatives; Infant, Newborn; Pregnancy; Ropivacaine; Sufentanil
PubMed: 35315623
DOI: 10.23736/S0375-9393.22.16284-X -
Knee Surgery, Sports Traumatology,... May 2016The purpose of this study was to appraise the efficacy and safety of single-dose intra-articular ropivacaine administered for pain relief after arthroscopic knee surgery. (Meta-Analysis)
Meta-Analysis Review
Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis.
PURPOSE
The purpose of this study was to appraise the efficacy and safety of single-dose intra-articular ropivacaine administered for pain relief after arthroscopic knee surgery.
METHODS
PubMed, Embase, and Cochrane Library databases were searched in October 2014 to identify randomized controlled trials of single-dose intra-articular ropivacaine for post-operative pain relief. Post-operative pain intensity, the amount of rescue analgesia required, and side effects including local anaesthetic toxicity were assessed. The relative risk (RR), the weighted mean difference (WMD), and their corresponding 95 % confidence intervals (CIs) were calculated.
RESULTS
Eight randomized controlled trials were included in the analysis. Statistically significant differences in the visual analogue scale for pain intensity value were observed during the immediate post-operative period (WMD -10.35, 95 % CI -17.12 to -3.59, p = 0.003) and the early post-operative period (WMD -11.90, 95 % CI -18.12 to -5.69, p = 0.0002), but not during the late post-operative period (WMD -2.89, 95 % CI -7.46 to 1.68, n.s.). There was no significant difference in the amount of rescue analgesia required (RR 0.76, 95 % CI 0.52-1.11, n.s.). Only two trials reported the incidence of drug-related side effects (including nausea and vomiting): the incidence in the ropivacaine groups was no higher than that in the control groups. Only one trial assessed local anaesthetic toxicity as an outcome, but it was not detected.
CONCLUSIONS
Single-dose intra-articular ropivacaine administered at the end of arthroscopic knee surgery provides effective pain relief in the immediate and early post-operative periods without increasing short-term side effects.
Topics: Amides; Anesthetics, Local; Arthroscopy; Chondrocytes; Humans; Injections, Intra-Articular; Knee Joint; Pain, Postoperative; Ropivacaine
PubMed: 26049805
DOI: 10.1007/s00167-015-3656-y -
International Journal of Molecular... Feb 2022Breast cancer (BC) is one of the most common types of cancer and the second leading cause of death in women. Local anaesthetics (LAs) and opioids have been shown to... (Review)
Review
Breast cancer (BC) is one of the most common types of cancer and the second leading cause of death in women. Local anaesthetics (LAs) and opioids have been shown to influence cancer progression and metastasis formation in several pre-clinical studies. However, their effects do not seem to promote consensus. A systematic review was conducted using the databases Medline (via PubMed), Scopus, and Web of Science (2010 to December 2021). Search terms included "lidocaine", "ropivacaine", "levobupivacaine", "morphine", "methadone", "breast cancer", "breast carcinoma" and "breast neoplasms" in diverse combinations. The search yielded a total of 784 abstracts for initial review, 23 of which met the inclusion criteria. Here we summarise recent studies on the effect of analgesics and LAs on BC cell lines and animal models and in combination with other treatment regimens. The results suggest that local anaesthetics have anti-tumorigenic properties, hence their clinical application holds therapeutic potential. Regarding morphine, the findings are conflicting, but this opioid appears to be a tumour-promoting agent. Methadone-related results are scarce. Additional research is clearly required to further study the mechanisms underlying the controversial effects of each analgesic or LA to establish the implications upon the outcome and prognosis of BC patients' treatment.
Topics: Anesthetics, Local; Animals; Breast Neoplasms; Cell Line, Tumor; Female; Humans; Levobupivacaine; Lidocaine; Morphine; Ropivacaine; Xenograft Model Antitumor Assays
PubMed: 35163815
DOI: 10.3390/ijms23031894 -
The Cochrane Database of Systematic... Jun 2023Epidural analgesia is often used for pain relief during labour and childbirth, and involves administration of local anaesthetics (LA) into the epidural space resulting... (Review)
Review
BACKGROUND
Epidural analgesia is often used for pain relief during labour and childbirth, and involves administration of local anaesthetics (LA) into the epidural space resulting in sensory blockade of the abdomen, pelvis, and perineum. Epidural opioids are often co-administered to improve analgesia. Administration of epidural medications can be accomplished by basal infusion (BI) or automated mandatory bolus (AMB). With BI, medications are administered continuously, while AMB involves injecting medications at set time intervals. Patient-controlled epidural analgesia (PCEA) on top of AMB or BI enables patients to initiate additional boluses of epidural medications. The superior method of delivering epidural medications would result in lower incidence of pain requiring anaesthesiologist intervention (breakthrough pain). Also, it should be associated with lower incidence of epidural-related adverse effects including caesarean delivery, instrumental delivery (use of forceps or vacuum devices), prolonged duration of labour analgesia, and LA consumption. However, clear evidence of the superiority of one technique over the other is lacking. Also, differences in the initiation of epidural analgesia such as combined spinal-epidural (CSE) (medications given into the intrathecal space in addition to the epidural space) compared to epidural only, and medications used (types and doses of LA or opioids) may not have been accounted for in previous reviews. Our prior systematic review suggested that AMB reduces the incidence of breakthrough pain compared to BI with no significant difference in the incidence of caesarean delivery or instrumental delivery, duration of labour analgesia, and LA consumption. However, several studies comparing AMB and BI have been performed since then, and inclusion of their data may improve the precision of our effect estimates.
OBJECTIVES
To assess the benefits and harms of AMB versus BI for maintaining labour epidural analgesia in women at term.
SEARCH METHODS
We searched CENTRAL, Wiley Cochrane Library), MEDLINE, (National Library of Medicine), Embase(Elseiver), Web of Science (Clarivate), the WHO-ICTRP (World Health Organization) and ClinicalTrials.gov (National Library of Medicine) on 31 December 2022. Additionally, we screened the reference lists of relevant trials and reviews for eligible citations, and we contacted authors of included studies to identify unpublished research and ongoing trials.
SELECTION CRITERIA
We included all randomised controlled studies that compared bolus dosing AMB with continuous BI during epidural analgesia. We excluded studies of women in preterm labour, with multiple pregnancies, with fetal malposition, intrathecal catheters, those that did not use automated delivery of medications, and those where AMB and BI were combined.
DATA COLLECTION AND ANALYSIS
We used standard methodology for systematic review and meta-analysis described by Cochrane. Primary outcomes included: incidence of breakthrough pain requiring anaesthesiologist intervention; incidence of caesarean delivery; and incidence of instrumental delivery. Secondly, we assessed the duration of labour; hourly LA consumption in bupivacaine equivalents, maternal satisfaction after fetal delivery, and neonatal Apgar scores. The following subgroup analyses were chosen a priori: epidural alone versus CSE technique; regimens that used PCEA versus those that did not; and nulliparous versus combination of nulli- and multi-parous women. We used the GRADE system to assess the certainty of evidence associated with our outcome measures.
MAIN RESULTS
We included 18 studies of 4590 women, of which 13 enrolled healthy nulliparous women and five included healthy nulli- and multiparous women. All studies excluded women with preterm or complicated pregnancies. Techniques used to initiate epidural analgesia differed between the studies: seven used combined spinal epidural, 10 used epidural, and one used dural puncture epidural (DPE). There was also variation in analgesics used. Eight studies utilised ropivacaine with fentanyl, three used ropivacaine with sufentanil, two utilised levobupivacaine with sufentanil, one used levobupivacaine with fentanyl, and four utilised bupivacaine with fentanyl. Most of the studies were assessed to have low risk of randomisation, blinding, attrition, and reporting biases, except for allocation concealment where eight studies were assessed to have uncertain risk and three with high risk. Our results showed that AMB was associated with lower incidence of breakthrough pain compared to BI (risk ratio (RR) 0.71; 95% confidence interval (CI) 0.55 to 0.91; I = 57%) (16 studies, 1528 participants), and lower hourly LA consumption in bupivacaine equivalents (mean difference (MD) -0.84 mg/h; 95% CI -1.29 to -0.38, I = 87%) (16 studies, 1642 participants), both with moderate certainty. AMB was associated with an estimated reduction in breakthrough pain incidence of 29.1% (incidence 202 per 1000, 95% CI 157 to 259), and was therefore considered clinically significant. The incidence of caesarean delivery (RR 0.85; 95% CI 0.69 to 1.06; I = 0%) (16 studies, 1735 participants) and instrumental delivery (RR 0.85; 95% CI 0.71 to 1.01; I = 0%) (17 studies, 4550 participants) were not significantly, both with moderate certainty. There was no significant difference in duration of labour analgesia (MD -8.81 min; 95% CI -19.38 to 1.77; I = 50%) (17 studies, 4544 participants) with moderate certainty. Due to differences in the methods and timing of outcome measurements, we did not pool data for maternal satisfaction and Apgar scores. Results reported narratively suggest AMB may be associated with increased maternal satisfaction (eight studies reported increased satisfaction and six reported no difference), and all studies showed no difference in Apgar scores. WIth the exception of epidural alone versus CSE which found significant subgroup differences in LA consumption between AMB and BI, no significant differences were detected in the remaining subgroup analyses.
AUTHORS' CONCLUSIONS
Overall, AMB is associated with lower incidence of breakthrough pain, reduced LA consumption, and may improve maternal satisfaction. There were no significant differences between AMB and BI in the incidence of caesarean delivery, instrumental delivery, duration of labour analgesia, and Apgar scores. Larger studies assessing the incidence of caesarean and instrumental delivery are required.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Analgesia, Epidural; Analgesics; Analgesics, Opioid; Breakthrough Pain; Levobupivacaine; Ropivacaine; Sufentanil; United States
PubMed: 37276327
DOI: 10.1002/14651858.CD011344.pub3 -
Journal of Perianesthesia Nursing :... Jun 2023This review aimed to conduct a meta-analysis of published randomized controlled studies (RCTs) comparing the effectiveness of dexmedetomidine (DEX) combined with... (Meta-Analysis)
Meta-Analysis
Analgesic Effects of Ropivacaine Combined With Dexmedetomidine in Transversus Abdominis Plane Block in Patients Undergoing Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.
PURPOSE
This review aimed to conduct a meta-analysis of published randomized controlled studies (RCTs) comparing the effectiveness of dexmedetomidine (DEX) combined with ropivacaine versus single ropivacaine in transversus abdominis plane block (TAPB) for postoperative analgesia after laparoscopic cholecystectomy (LC). The purpose was to investigate whether DEX combined with ropivacaine in TAPB for postoperative analgesia in LC is superior to single ropivacaine administration.
DESIGN
A Systematic Review and Meta-analysis.
METHODS
Five electronic database systems were searched for RCTs on the effects of DEX combined with ropivacaine (joint group) and single ropivacaine on postoperative analgesia in LC. The standardized mean difference (SMD) or odds ratio (OR) and their corresponding 95% confidence interval (CI) of the indicators were calculated for comparison.
FINDINGS
As of December 23, 2021, 153 articles were retrieved, but only 16 articles were finally included in this meta-analysis. The results showed that compared with single ropivacaine, DEX combined with ropivacaine in TAPB had better analgesia and lighter sedative effect in patients after LC. After LC 2h(T1), 4h(T2), 8h(T3), 12h(T4) and 24h (T5), the joint group participants have lower VAS scores (T1: SMD = -0.32, 95%CI: -0.49, -0.14; T2: SMD = -1.11, 95%CI: -1.56, -0.65; T3: SMD = -2.88, 95%CI: -3.74, -2.02; T4: SMD = -2.56, 95%CI: -3.04, -2.08; T5: SMD = -1.44, 95%CI: -1.81, -1.06). Also, the Ramsay score of the joint group is higher than the single group (T1: SMD = 1.05, 95%CI: 0.39, 1.71; T2: SMD = 1.57, 95%CI: 0.57, 2.57; T3: SMD = 1.64, 95%CI: 0.65, 2.63; T4: SMD = 1.72, 95%CI: 0.54, 2.89; T5: SMD = 0.57, 95%CI: 0.21, 0.94).
CONCLUSIONS
The results of this review and meta-analysis suggest that DEX combined with ropivacaine has less postoperative pain, more patients got the status of sober and cooperative, and longer postoperative analgesia lasted than ropivacaine alone in TAPB, especially in the group of combined treatment with 1.0 mcg/kg DEX. Furthermore, the flow dynamics of the two groups are stable, and there is no notable difference in the incidence of adverse reactions.
Topics: Humans; Ropivacaine; Dexmedetomidine; Cholecystectomy, Laparoscopic; Anesthetics, Local; Pain, Postoperative; Abdominal Muscles; Analgesics
PubMed: 36710235
DOI: 10.1016/j.jopan.2022.09.003