{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:42:43Z","timestamp":1792726963443,"version":"4.5.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Ropivacaine is a long-acting local anesthetic that is used to treat postoperative pain. Adjuvant use of dexmedetomidine in regional anesthesia may prolong the duration of analgesia. The objective of this systematic review and meta-analysis was to investigate the duration and effect of ropivacaine alone vs. ropivacaine in combination with dexmedetomidine for postoperative analgesia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The PubMed, EMBASE, Web of Science, and Google Scholar databases were searched for randomized controlled trials (RCTs) of ropivacaine alone or ropivacaine in combination with dexmedetomidine for regional anesthesia. The primary outcome was duration of analgesia, defined as the time from onset of the block to the time of the first analgesic request or initial pain report. Secondary outcomes were duration of sensory block, duration of motor block, consumption of sufentanil for analgesia, length of hospital stay, and incidence of postoperative nausea and vomiting.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eighteen studies with 1148 patients were included. Overall quality of the RCTs, as assessed by the Jadad scale, was high. The meta-analysis demonstrated that ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia from local anesthetics compared to ropivacaine alone (WMD: 4.14h; 95%CI: 3.29~5.0h; <jats:italic>P<\/jats:italic>&lt;0.00001; I<jats:sup>2<\/jats:sup> = 99%). There was evidence of high heterogeneity between studies. The duration of sensory and motor block was significantly increased, and consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting were significantly reduced in patients who received ropivacaine combined with dexmedetomidine compared to ropivacaine alone. There was no significant difference in length of hospital stay.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Compared to ropivacaine alone, ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia and sensory and motor block, and reduced consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting, across an array of surgeries.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0287296","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T17:32:28Z","timestamp":1697045548000},"page":"e0287296","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Effects of dexmedetomidine as an adjuvant to ropivacaine or ropivacaine alone on duration of postoperative analgesia: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5911-0082","authenticated-orcid":true,"given":"Fangzhou","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9776-6258","authenticated-orcid":true,"given":"Linghui","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"issue":"2","key":"pone.0287296.ref001","doi-asserted-by":"crossref","first-page":"290","DOI":"10.52312\/jdrs.2021.68","article-title":"A randomized comparative evaluation of local infiltration analgesia, extended nerve blocks, and conventional analgesia in pain management after total knee arthroplasty","volume":"32","author":"C Kopitko","year":"2021","journal-title":"Jt Dis Relat Surg"},{"issue":"1","key":"pone.0287296.ref002","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12871-018-0485-9","article-title":"Preoperative versus postoperative ultrasound-guided rectus sheath block for improving pain, sleep quality and cytokine levels in patients with open midline incisions undergoing transabdominal gynecological surgery: a randomized-controlled trial.","volume":"18","author":"F Jin","year":"2018","journal-title":"BMC Anesthesiol."},{"issue":"4","key":"pone.0287296.ref003","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1177\/1558944719843635","article-title":"Upper-Extremity Nerve Decompression Under Local Anesthesia: A Systematic Review of Methods for Reduction of Postoperative Pain and Opioid Consumption.","volume":"15","author":"Y Chocron","year":"2020","journal-title":"Hand (N Y)."},{"issue":"5","key":"pone.0287296.ref004","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.dld.2020.11.028","article-title":"Ultrasound-guided stellate ganglion block alleviates stress responses and promotes recovery of gastrointestinal function in patients","volume":"53","author":"G Zhu","year":"2021","journal-title":"Dig Liver Dis"},{"issue":"5","key":"pone.0287296.ref005","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11916-020-00853-z","article-title":"Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain.","volume":"24","author":"AD Kaye","year":"2020","journal-title":"Curr Pain Headache Rep."},{"issue":"2","key":"pone.0287296.ref006","doi-asserted-by":"crossref","first-page":"447","DOI":"10.21037\/apm.2020.03.25","article-title":"Impacts of different administration modes of dexmedetomidine with 0.5% ropivacaine on intercostal nerve block.","volume":"9","author":"F Yao","year":"2020","journal-title":"Ann Palliat Med"},{"issue":"14","key":"pone.0287296.ref007","doi-asserted-by":"crossref","first-page":"e25272","DOI":"10.1097\/MD.0000000000025272","article-title":"Evaluation of ropivacaine combined with dexmedetomidine versus ropivacaine alone for epidural anesthesia: A meta-analysis.","volume":"100","author":"J Zhao","year":"2021","journal-title":"Medicine (Baltimore)."},{"issue":"6","key":"pone.0287296.ref008","doi-asserted-by":"crossref","first-page":"e118667","DOI":"10.5812\/aapm.118667","article-title":"Comparison of Intercostal Nerve Block with Ropivacaine and Ropivacaine-Dexmedetomidine for Postoperative Pain Control in Patients Undergoing Thoracotomy: A Randomized Clinical Trial.","volume":"11","author":"K Mahmoudi","year":"2021","journal-title":"Anesth Pain 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Rev."},{"key":"pone.0287296.ref014","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"JP Higgins","year":"2011","journal-title":"BMJ"},{"issue":"1","key":"pone.0287296.ref015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary? [J].","volume":"17","author":"A R Jadad","year":"1996","journal-title":"Control Clin Trials."},{"key":"pone.0287296.ref016","first-page":"1846886","article-title":"Thoracic Paravertebral Nerve Block with Ropivacaine and Adjuvant Dexmedetomidine Produced Longer Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Trial.","volume":"2021","author":"J Zha","year":"2021","journal-title":"J Healthc Eng."},{"issue":"1","key":"pone.0287296.ref017","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/AJP.0000000000000992","article-title":"Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy: A Randomized, Controlled Clinical Study.","volume":"38","author":"Q Wang","year":"2021","journal-title":"Clin J Pain"},{"key":"pone.0287296.ref018","article-title":"Dexamethasone and dexmedetomidine as adjuvants to local anesthetic mixture in intercostal nerve block for thoracoscopic pneumonectomy: a prospective randomized study.","author":"P Zhang","year":"2019","journal-title":"Reg Anesth Pain Med"},{"issue":"4","key":"pone.0287296.ref019","doi-asserted-by":"crossref","first-page":"457","DOI":"10.4103\/joacp.JOACP_298_16","article-title":"Dexmedetomidine as an adjunctive analgesic to ropivacaine in pectoral nerve block in oncological breast surgery: A randomized double-blind prospective study","volume":"33","author":"H Kaur","year":"2017","journal-title":"Journal of Anaesthesiology Clinical Pharmacology"},{"issue":"2","key":"pone.0287296.ref020","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1007\/s40122-021-00320-6","article-title":"Effect of Different Modes of Administration of Dexmedetomidine Combined with Nerve Block on Postoperative Analgesia in Total Knee Arthroplasty","volume":"10","author":"XB Jin","year":"2021","journal-title":"Pain 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dexmedetomidine in elderly high-risk patients.","volume":"84","author":"L Xu","year":"2018","journal-title":"Minerva Anestesiol."},{"issue":"1","key":"pone.0287296.ref030","first-page":"38","article-title":"Comparative study of analgesic effi cacy of ropivacaine with ropivacaine plus dexmedetomidine for paravertebral block in unilateral renal surgery [J].","volume":"16","author":"S Sinha","year":"2012","journal-title":"ANAESTH, PAIN & INTENSIVE CARE"},{"issue":"4","key":"pone.0287296.ref031","first-page":"2535","article-title":"Dexmedetomidine combined with ropivacaine in ultrasound-guided tranversus abdominis plane block improves postoperative analgesia and recovery following laparoscopic colectomy.","volume":"19","author":"W Pan","year":"2020","journal-title":"Exp Ther Med"},{"issue":"7","key":"pone.0287296.ref032","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative Multimodal Analgesia Pain Management With Nonopioid 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Kehlet","year":"2018","journal-title":"Pain"},{"issue":"10","key":"pone.0287296.ref036","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s11906-022-01205-5","article-title":"The Effects of Pain and Analgesic Medications on Blood Pressure.","volume":"24","author":"G Rivasi","year":"2022","journal-title":"Curr Hypertens Rep"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0287296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T17:32:51Z","timestamp":1697045571000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0287296"}},"subtitle":[],"editor":[{"given":"Lalit","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,10,11]]},"references-count":36,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0287296","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,11]]}}}