Effect Of Dexmedetomidine On Pain After Laparoscopic Cholecystectomy:A Meta-analysis

Objective:To evaluate systemically the effect of dexmedetomidine on postoperative pain after laparoscopic cholecystectomy（LC）.Methods:Two researchers independently searched Wanfang database,CNKI Chinese Journal Full-text Database,PubMed database,Embase database,Cochrane Library and CBM to extract the data according to inclusion and exclusion criteria strictly.During the process of data integration,the relevant data of pain score at 2-4h,6-8h,12h and 24h after LC,extubation time and complications were extracted,and the corresponding mean difference（MD）,relative risk（RRs）and 95%Confidence Intervals（95%CI）were calculated.Results:Eighteen^{[3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20]}trials with 1363 patients were included in this meta-analysis.（1）Patients receiving dexmedetomidine had lower pain scores at2-4h（SMD,-2.41;95%CI:-3.04^-1.78;P<0.00001）,6-8h（SMD,-1.63;95%CI:-2.39^-0.88;P<0.0001）,12h（SMD,-1.69;95%CI:-2.20^-1.17;P<0.00001）and 24h（SMD,-1.33;95%CI:-1.88^-0.78;P<0.00001）after LC.（2）The time of extubation after LC was longer in dexmedetomidine group than in control group（MD,5.33second,95%CI:1.60⁹.05;P=0.005）.（3）Dexmedetomidine could significantly reduce the incidence of postoperative nausea and vomiting（[RR]=0.47;95%CI:0.29⁰.77;P=0.003）,shivering（[RR]=0.43;95%CI:0.21⁰.88;P=0.02）,dysphoria（[RR]=0.20;95%CI:0.11⁰.40;P<0.00001）and increase the incidence of bradycardia（[RR]=3.35;95%CI:1.66⁶.75;P=0.0007）comparingwiththecontrolgroup.（4）Dexmedetomidine-treated patients required less rescue analgesia for intolerable pain（[RR]=0.33;95%CI:0.23⁰.46;P<000001）.Conclusions:The fingdings indicate that dexmedetomidine could reduce postoperative pain after laparoscopic cholecystectomy.In addition,dexmedetomidine could significantly reduce the incidence of postoperative nausea and vomiting、shivering、dysphoria and increase the incidence of bradycardia.