Efficacy and duration of analgesia with levobupivacaine combined with fentanyl or dexmedetomidine in lower extremity surgery: A meta-analysis

Authors

DOI:

https://doi.org/10.71152/ajms.v16i3.4352

Keywords:

Spinal block; Post-operative pain; Adjuvant; Sensory block; Motor block

Abstract

Background: In combination with local anesthetics such as levobupivacaine, fentanyl, and dexmedetomidine improve post-operative analgesia after surgery on the lower extremities.

Aims and Objectives: To determine whether the local anesthetic levobupivacaine in combination with fentanyl or dexmedetomidine can improve the efficacy and duration of analgesia in lower extremity surgery.

Materials and Methods: After a search in PubMed, Google, and Web of Science, six randomized controlled trials with 400 patients were found. Review Manager 5 was then used to retrieve the study results and calculate the effect sizes.

Results: The effects of 0.5% levobupivacaine with fentanyl (group F) and dexmedetomidine (group D) on sensory blockade, regression, and post-operative analgesia were investigated in numerous studies. Group D had a significant advantage in sensory regression (standard mean difference [SMD] −3.34, confidence interval [CI] [−4.07, −2.62], P<0.00001), although there was no significant difference in the onset of sensory blockade (SMD −0.21, CI [−1.28, 0.86], dexmedetomidine prolonged post-operative analgesia (SMD −7.34, CI [−11.08, −3.60], P=0.0001). The heterogeneity between the studies was substantial (I²=59–97%). The methodological excellence of the selected studies was reflected in their low risk of bias in all areas.

Conclusion: Despite the identical onset of sensory blockade, dexmedetomidine prolongs sensory regression and post-operative analgesia more than fentanyl. Despite considerable variability, these results are supported by a low bias, making dexmedetomidine a better adjuvant for analgesia in chronic lower extremity surgery.

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Published

2025-03-01

How to Cite

Gupta, M., Pratap, R., & Singh, G. P. (2025). Efficacy and duration of analgesia with levobupivacaine combined with fentanyl or dexmedetomidine in lower extremity surgery: A meta-analysis. Asian Journal of Medical Sciences, 16(3), 15–23. https://doi.org/10.71152/ajms.v16i3.4352

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Original Articles

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