Effects of ropivacaine alone or in combination with dexmedetomidine on cesarean section: a systematic review and meta-analysis

Objective: Different from physiological pain, post-operative pain is caused by surgical trauma.We aimed to systematically assess the effects of ropivacaine alone or in combination with dexmedetomidine on cesarean section and to conduct a metaanalysis.Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and Cochrane intervention system review manual, retrieval software and data analysis tools were used for literature retrieval, screening, exclusion and inclusion, data extraction, analysis and statistics, and risk assessment.A total of 37 literatures were retrieved, and 11 literatures were left after 26 duplicates were excluded.Results: A total of 37 literatures were retrieved in all databases, of which 11 literatures were left and finally 7 all published in English were obtained.They were seven randomized controlled trials on ropivacaine alone or in combination with dexmedetomidine applied in 502 parturients receiving cesarean section.The results of meta-analysis on main outcome indices showed that the number of parturients in need of rescue ( 2 = 28.62,p < 0.001, I 2 = 93%), incidence rate of adverse reactions ( 2 = 28.66,p = 0.007, I 2 = 55%), satisfaction ( 2 = 7.97, p = 0.05, I 2 = 62.3%), visceral respiratory response ( 2 = 19.26,p < 0.001, I 2 = 89.6%),satisfaction with muscle relaxation ( 2 = 6.92, p = 0.03, I 2 = 71.1%),and spinal anesthesia grade ( 2 = 25.89,p < 0.01, I 2 = 92.3%).Conclusions: Ropivacaine combined with dexmedetomidine has a better prognostic effect on cesarean section and causes fewer adverse reactions.