Effects of dexmedetomidine as a perineural adjuvant for femoral nerve block: A systematic review and meta-analysis.

Abstract

BackgroundFemoral nerve block (FNB) is one of the first-line analgesic methods for patients following lower extremity surgery. However, FNB with local anesthetics alone exert limited potency and supplemental opioids are often required. Dexmedetomidine (DEX) has been used to improve the analgesic effects of FNB. The present systematic review and meta-analysis were conducted to evaluate the effectiveness of DEX as an adjuvant to local anesthetics for FNB.MethodsRandomized controlled trials comparing the effects of DEX versus sham control in combination with local anesthetics for FNB were included in this meta-analysis. Postoperative pain scores, duration of analgesic effects, and postoperative narcotic consumption were outcomes of interest. This research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements.ResultsA total of 9 studies encompassing 580 participants were included for data synthesis after critical evaluation. DEX as an adjuvant with local anesthetics for FNB significantly relieved pain intensity at 12, 24 and 48 hours after surgery, both at rest (standardized mean difference -1.34 [95% CI -1.87 to -0.82], PConclusionDEX as an adjuvant to local anesthetics for FNB improves analgesia, prolongs analgesic duration and reduces supplemental opioid consumption; but increases hypotension.