Medicine
Parham Maroufi; Mahdi Nazari
Abstract
Introduction: This systematic review aims to evaluate the analgesic effect of intravenous dexamethasone in patients undergoing volar plate surgery for distal radius fractures. The findings of this review will provide valuable insights into the potential role of dexamethasone as an adjunctive analgesic ...
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Introduction: This systematic review aims to evaluate the analgesic effect of intravenous dexamethasone in patients undergoing volar plate surgery for distal radius fractures. The findings of this review will provide valuable insights into the potential role of dexamethasone as an adjunctive analgesic agent in this surgical setting. By synthesizing the available evidence, this review aims to contribute to the existing literature and guide clinical decision-making regarding postoperative pain management strategies. Material and Methods: Data extraction was performed independently by two reviewers using a standardized data extraction form. The following information was collected: study characteristics (author, year of publication, study design), patient demographics (sample size, age, sex), surgical details (type of volar plate surgery, anesthesia technique), intervention details (dose, timing, and duration of intravenous dexamethasone administration), control group characteristics, outcome measures, and relevant results. Any discrepancies were resolved through discussion and consensus. Results: The primary outcome measure assessed in the included studies was postoperative pain intensity. Pain intensity scores were evaluated using various validated pain rating scales, including the visual analog scale (VAS) and numerical rating scale (NRS). Secondary outcome measures included postoperative opioid consumption, time to first analgesic request, duration of analgesic effect, adverse effects related to dexamethasone administration, and patient satisfaction scores. Conclusion: this systematic review provides evidence supporting the analgesic effect of intravenous dexamethasone following volar plate surgery for distal radius fractures. Dexamethasone effectively reduces postoperative pain intensity, opioid consumption, and the need for rescue analgesia. The sustained analgesic effect and favorable safety profile make dexamethasone a promising adjunctive analgesic in this surgical setting.
Medicine
Mohammad Reza Moharrami; Mahdi Nazari
Abstract
Introduction: This systematic review aims to compare the efficacy and safety of low-dose intravenous ketamine-midazolam with intravenous morphine for pain control in patients with hand fractures. By synthesizing the available evidence, we seek to provide clinicians with valuable insights into the potential ...
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Introduction: This systematic review aims to compare the efficacy and safety of low-dose intravenous ketamine-midazolam with intravenous morphine for pain control in patients with hand fractures. By synthesizing the available evidence, we seek to provide clinicians with valuable insights into the potential benefits and limitations of these analgesic strategies, aiding in informed decision-making for optimal pain management in this patient population. Material and Methods: This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure transparency and methodological rigor in the review process. Results: The primary outcome of pain control was assessed using various pain scales, including the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS). The majority of studies reported comparable pain control between low-dose ketamine-midazolam and intravenous morphine. Both analgesic regimens resulted in significant pain reduction. A subset of studies demonstrated that low-dose ketamine-midazolam provided superior pain control compared to intravenous morphine, particularly in the immediate post-intervention period. However, the overall evidence regarding the superiority of one regimen over the other was inconclusive due to variations in study designs, sample sizes, and outcome measures. Conclusion: Low-dose intravenous ketamine-midazolam and intravenous morphine are both effective analgesic regimens for pain control in patients with hand fractures. While the evidence regarding the superiority of one regimen over the other remains inconclusive, low-dose ketamine-midazolam appears to offer comparable pain control with reduced opioid consumption anda favorable safety profile.
