The Efficacy of Antipyretic Analgesics Administration Intravenously for Preventing Rocuronium-Associated Pain/Withdrawal Response: A Systematic Review and Meta-Analysis
Abstract Background Rocuronium-associated injection pain/withdrawal response (RAIPWR) was non-ideal but occurred frequently when injection intravenously during anesthesia induction. Many studies had reported that pretreating with antipyretic analgesics (AAs) could reduce the occurrence of RAIPWR, but there was no consensus yet. Therefore, this meta-analysis was designed to systematically evaluate the benefits of AAs on RAIPWR in patients.Methods PubMed, Cochrane Library, Ovid, EMbase, Chinese National Knowledge Infrastructure (CNKI), Wan Fang Data were searched by January 1st 2019 for randomized controlled trials (RCTs) applying AAs to alleviate RAIPWR in patients underwent elective surgery under general anesthesia. Two investigators assessed quality of RCTs and extracted data independently and the meta-analysis was carried on Revman 5.3 software. Plus, we also compared AAs with lidocaine in pros and cons directly, the most reported medicine to prevent RAIPWR.Results Data were analyzed from 10 RCTs totaling 992 patients. The results of Meta-analysis showed that compared to the control group, pretreating with AAs could prevent the total occurrence of RAIPWR [Risk ratio (RR), 0.51; 95% confidence interval (CI), 0.41 to 0.64; P < 0.0001], and took effect on moderate (RR, 0.49; 95%CI, 0.39 to 0.63; P<0.0001) and severe RAIPWR (RR=0.14; 95%CI, 0.08 to 0.24; P<0.00001). When compared to lidocaine, the preventive effect was not so excellent as the latter but injection pain induced by prophylactic occurred less.Conclusion The available evidence suggested that pretreating with AAs intravenously could alleviate RAIPWR.