Efficacy of Intravenous Dexmedetomidine Versus Lidocaine on Postoperative Gynecological Surgery: Systematic Review and Meta-Analysis
Aiman Hilmi Asaduddin(a*), Mentari Maratus Sholihah(b), Taufik Ridwan Hadi Kusuma(c), Azkia Rachmah(a)

a) Medical Professional Education, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
*aimanhilmi02[at]student.uns.ac.id
b) Medical Doctor, Internship, RSUP Dr Sitanala, Tangerang, Banten, Indonesia
c) Medical Doctor, Internship, RSPAU dr. S. Hardjolukito, Yogyakarta, Special Region of Yogyakarta, Indonesia

Abstract

Background: Dexmedetomidine and lidocaine are two postoperative therapy regimens commonly used in gynecological surgery. Many studies suggest that these two regimens are promising agents for managing the transition from acute to chronic postoperative pain that occurs frequently during the rehabilitation of gynecological patients. Furthermore, the administration of these two regimens improves the procedure and quality of gynecological surgery recovery.
Objective: We conducted a comprehensive evaluation of systematic review and meta-analysis to assess the efficacy of intravenous dexmedetomidine and lidocaine on gynecological postoperative follow up.
Methods: We conducted this study based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Several scientific databases, namely Scopus, ScienceDirect, Springer Link, and PubMed, were searched for randomized, controlled studies that compared intravenous administration of dexmedetomidine and lidocaine in adult patients undergoing gynecological surgery and reported postoperative outcomes.
Results: From 236 articles found, four articles were included for further analysis and discussion. Dexmedetomidine reduces the VAS score in 2 h (MD -0.30, p=0.001) 12 h (MD -0.39, p=0.004), and 24 h (MD -0.15, p=0.03) after operation compared to lidocaine. Additionally, combination of dexmedetomidine and lidocaine further reduces the VAS score in 2 h (MD -0.70, p<0.001) and 12 h (MD - 0.81, p=0.03) after operation compared to dexmedetomidine alone.
Conclusion: Intravenous administration of dexmedetomidine is more potent in reducing postoperative pain after gynecological surgery compared to lidocaine. However, the combination of intravenous lidocaine and dexmedetomidine provides the best pain management compared to lidocaine or dexmedetomidine alone.

Keywords: Dexmedetomidine- Lidocaine- Intravenous Anesthetic- Gynecological Surgery- Postoperative Evaluation- Systematic Review- Meta-analysis

Topic: Medical : basic science, clinical, translational research, medical education, and miscellaneous