Effect Of Dexmedetomidine Combined With Local Anesthetics In Thoracic Paravertebral Block In Thoracic Surgery:A Meta-analysis

Objective:To evaluate effect of perioperative analgesia and safety of dexmedetomidine combined with local anesthetics in thoracic paravertebral block in thoracic surgery patients by meta-analysis.Methods: A systematic search was performed in Pub Med,Cochrane,Web of science,Embase,CNKI,Wan Fang and VIP databases from inception to September 2021 to collect randomized controlled trials(RCTs)of dexmedetomidine combined with local anesthetics in thoracic paravertebral block in thoracic surgery,involving the efficacy of single block of local anesthetics in thoracic paravertebral block.The methodological quality of the included randomized controlled trials(RCTs)was assessed and the data were extracted according to the Cochrane Handbook.The meta-analysis was performed by using Rev Man 5.3 software.Results: Ten RCTs involving 581 patients were included,291 patients in the DEX group and 290 patients in the control group.The results of the Meta-analysis showed that the postoperative 12 and 24 hours VAS pain scores at rest and dynamic(SMD=-0.34,95%CI-0.58～-0.09,P﹤0.05)(SMD=-0.58,95%CI-1.03 ～-0.13,P ﹤ 0.05)(SMD=-0.55,95 % CI-0.90 ～-0.21,P ﹤ 0.05;)(SMD=-1.11,95%CI-1.93～-0.30,P﹤0.05),consumption of postoperative analgesics(SMD=-0.11,95%CI-0.16～-0.07,P﹤0.05)of the DEX group were lower than those of the control group.There was no significant difference in Nausea and vomiting,the number of cases of rescue analgesia after operation,hypotension,bradycardia and atelectasis between these groups.Conclusion: Dexmedetomidine combined with local anesthetics in thoracic paravertebral block significantly improved postoperative pain scores at rest and dynamic and reduced postoperative analgesic consumption,but the incidence of postoperative adverse reactions is similar.