Eutectic mixture of local anaesthetics for pain reduction during extracorporeal shockwave lithotripsy: A systematic review and meta-analysis.

• 影响指数: 3.752
• 发表时间: 2020
• 来源期刊: PLoS One
• DOI: 10.1371/journal.pone.0237783
• PMID: 33017397
• 文章类型: Journal Article
• 中科院分区: Q2
• 方向: 综合性期刊
• 作者列表: Wang Z,Chen G,Wang J,Wei W

Mesh: Administration, Cutaneous; Analgesia / methods; Anesthesia, Local / methods; Anesthetics, Combined / administration & dosage; Anesthetics, Local / administration & dosage; Humans; Lidocaine, Prilocaine Drug Combination / administration & dosage; Lithotripsy / adverse effects methods; Pain Management / methods; Pain, Postoperative / drug therapy

Abstract

A systematic review and meta-analysis was conducted to explore the effect of a eutectic mixture of local anaesthetics (EMLA) on pain reduction during extracorporeal shockwave lithotripsy (ESWL). PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2020) were searched for randomised controlled trials (RCTs) assessing the effect of EMLA for patients that underwent ESWL. The search strategy and study selection process were managed according to the PRISMA statement. Six RCTs were included in the meta-analysis. Overall, the results indicated that EMLA significantly reduced pain compared to the control group (RR = -2.98, 95% CI = -5.82 to -0.13, P = 0.04) with a heterogeneity of I2 = 57% (P = 0.04). Subgroup analysis showed that EMLA did not significantly reduce pain when the patients took an analgesic premedication (RR = -1.46, 95% CI = -5.89 to 2.98, P = 0.52) with a heterogeneity of I2 = 38% (P = 0.52). Conversely, studies without premedication showed a significant pain relief effect (RR = -4.08, 95% CI = -7.36 to -0.65, P = -0.80) with a heterogeneity of I2 = 48% (P = 0.14). Most studies showed there was no difference in the patient\'s need for analgesics. EMLA was effective for reducing pain during EWSL. However, this analgesic effect was limited and did not reduce the need for analgesics.