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ORIGINAL ARTICLE
Year : 2015  |  Volume : 18  |  Issue : 2  |  Page : 256-262

Combined low dose local anesthetics and opioids versus single use of LA for transurethral urological surgery: A meta-analysis


1 Department of Anaesthesiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, 20 Yuhuangding East Road, Yantai 264000, China
2 Department of Operation Room, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, 20 Yuhuangding East Road, Yantai 264000, China

Correspondence Address:
Y Chi
Department of Anaesthesiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, 20 Yuhuangding East Road, Yantai 264000
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1119-3077.151055

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Introduction: The combination of reduced dose of local anesthetics (LA) and highly lipid-soluble synthetic opioids for patients undergoing transurethral surgery could reduce block duration and side-effects. However, it remains unclear what are the most appropriate levels of low dose and the extent to which the side-effects could be controlled. A meta-analysis was conducted to address this concern. Materials and Methods: Based on twelve randomized controlled trials, this meta-analysis pooled previous results to generate integrated evidence. Results: Combined low dose of LA and opioids had similar sensory block and significantly shorter motor block duration (weighted mean difference: -39.31 min, 95% confidence interval (CI): -50.58-−28.05, P < 0.00001) compared with single use of LA. There was no evidence of higher risk of analgesic failure in the combination group. In addition, combined low dose LA and opioids was associated with significantly reduced rate of postoperative hypotension (risk ratios (RR): 0.60, 95% CI: 0.37-0.96, P = 0.03) and shivering (RR: 0.27, 95% CI: 0.11-0.64, P = 0.003), but with higher rate of sedation (RR: 3.14, 95% CI: 1.02-9.66, P = 0.05). Conclusion: Combined low dose LA and opioids is a better choice for patients received transurethral surgery compared with single use of intrathecal LA.


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